Stroke Risk After Coronary Artery Bypass Graft Surgery and Extent of Cerebral Artery Atherosclerosis

Lee, Eun Jae; Choi, Kyoung Hyo; Ryu, Ju Seok; Jeon, Sang Beom; Lee, Seung Whan; Park, Seong Wook; Park, Seung Jung; Lee, Jae Won; Choo, Suk Jung; Chung, Cheol Hyun; Jung, Sung Ho; Kang, Dong Wha; Kim, Jong Seung; Kwon, Sun U.

doi:10.1016/j.jacc.2010.12.026

Cited by 80 publications

(66 citation statements)

References 20 publications

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“…Interestingly, there was no associated increased risk of stoke in patients with POAF. Postoperative stroke has been associated with the extent of cerebral artery atherosclerosis, 22 extent of atherosclerotic ascending aortic disease, 23 older age, on-pump CABG surgery with hypothermia circulatory arrest, 24 increased cardiopulmonary bypass duration, 25 and POAF. 25,20 However, the historical association between POAF and stroke has been inconsistent.…”

Section: Resultsmentioning

confidence: 99%

Postoperative Atrial Fibrillation Is Not Associated With an Increase Risk of Stroke or the Type and Number of Grafts: A Single‐Center Retrospective Analysis

Lotfi

Wartak

Sethi

et al. 2011

Clinical Cardiology

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Background:Atrial fibrillation (AF) and atrial flutter are the 2 most common types of dysrhythmia in patients undergoing coronary artery bypass graft (CABG) surgery and are associated with increased morbidity and mortality. We sought to explore the association between the type and quantity of bypass grafts and cardiovascular outcomes in patients with postoperative AF (POAF).Hypothesis:The type and quantity of bypass grafts is associated with POAF.Methods:We queried the Society of Thoracic Surgery National Database for CABG operations, both with and without valve procedures, performed at Baystate Medical Center between January 2002 and July 2007. We used multivariable logistic regression modeling to identify predictors of POAF and to explore the impact of AF on major adverse cardiac outcomes in this post‐CABG population.Results:A total of 3068 patients received CABG surgery, 187 (6.1%) of whom received concurrent valve replacement or repair. The incidence of POAF was 38.3%. POAF was significantly associated with readmission within 30 days (P < 0.009), increased length of stay (P << 0.0001), and a strong trend toward increased 30 day mortality (P = 0.058). There was no association between POAF and postoperative stroke (P = 0.92), graft type (P = nonsignificant) or number of grafts (P = nonsignificant).Conclusions:Patients with POAF experienced increased morbidity and mortality as demonstrated by previous studies. Neither the number of grafts nor type of grafts was associated with POAF. Furthermore, the rate of stroke was not associated with POAF. © 2011 Wiley Periodicals, Inc.The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Section: Resultsmentioning

confidence: 99%

Postoperative Atrial Fibrillation Is Not Associated With an Increase Risk of Stroke or the Type and Number of Grafts: A Single‐Center Retrospective Analysis

Lotfi

Wartak

Sethi

et al. 2011

Clinical Cardiology

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“…Bu nedenle inmenin, karotis darlığı ile ilişkisi yanında, gelişen aterosklerotik hadise ile daha fazla ilişkili olduğu ileri sürülmüştür. [8] Lee ve ark., [9] intrakraniyal aterosiklerozun, inmenin temel belirleyicileri olduğunu, ekstrakraniyal aterosklerotik olayların da nadiren inme etkeni olabileceğini bildirmişlerdir. Yazarlar bildirilerinde 1367 olguyu (ameliyat öncesi ve sonrası) serebral MR anjiyografi ile değerlendir-miş ve inme gelişen 33 olgu tespit etmişlerdir.…”

Section: Discussionunclassified

The effect of degree of stenosis and surgical timing on stroke and mortality in patients with carotid artery stenosis who are undergoing coronary bypass grafting: Retrospective study

Vural¹

2015

Turk Gogus Kalp Dama

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“…The severity of stenosis was visually graded (0 indicating Ͻ50% stenosis; 1 indicating 50%-99% stenosis, and 2 indicating occlusion) The "atherosclerosis score" was defined as the sum of the scores of steno-occlusive intracranial and extracranial arteries. 12 …”

Section: Mri and Analysismentioning

confidence: 99%

Insufficient Platelet Inhibition Is Related to Silent Embolic Cerebral Infarctions After Coronary Angiography

Kim

Lee

Park

et al. 2012

Stroke

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Background and Purpose-Considering that insufficient platelet inhibition is related to thrombotic complications after coronary angiography, we hypothesized that the extent of platelet inhibition by antiplatelet agents is related to the occurrence of silent embolic cerebral infarction (SECI) after coronary angiography. Methods-Among the patients scheduled for coronary artery bypass surgery, we retrospectively analyzed the location of SECI on diffusion-weighted imaging of 272 patients, which was performed after coronary angiography, as a presurgical evaluation in Phase 1 study. In Phase 2 study, we have prospectively recruited 102 patients to compare the extent of platelet inhibition measured by the VerifyNow system among patients with and without SECI. Results-SECI is observed in 45 patients (16.5%) in Phase 1 and 17 (16.7%) in Phase 2. The lesions were slightly more frequent in the right hemisphere. In the Phase 2 study, aspirin reaction units and P 2 Y 12 reaction units were higher in the patients with SECI than those without (aspirin reaction units: 490Ϯ72 versus 446Ϯ53, Pϭ0.03; P 2 Y 12 reaction units: 352Ϯ65 versus 300Ϯ77, Pϭ0.009). The incidence of SECI increased with the number of resistant antiplatelets; resistance to both antiplatelet agent (50%), resistance to 1 antiplatelet agent (22%), and no resistance (4%; Pϭ0.023).From the result of logistic regression, higher aspirin reaction units, white blood cell count, low hemoglobin, and nonresponsiveness to antiplatelet agents were independent risk factors. Conclusions-Insufficient platelet inhibition after administration of antiplatelet agents is related with SECI appearing after coronary angiography. (Stroke. 2012;43:727-732.)

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Stroke Risk After Coronary Artery Bypass Graft Surgery and Extent of Cerebral Artery Atherosclerosis

Cited by 80 publications

References 20 publications

Postoperative Atrial Fibrillation Is Not Associated With an Increase Risk of Stroke or the Type and Number of Grafts: A Single‐Center Retrospective Analysis

Postoperative Atrial Fibrillation Is Not Associated With an Increase Risk of Stroke or the Type and Number of Grafts: A Single‐Center Retrospective Analysis

The effect of degree of stenosis and surgical timing on stroke and mortality in patients with carotid artery stenosis who are undergoing coronary bypass grafting: Retrospective study

Insufficient Platelet Inhibition Is Related to Silent Embolic Cerebral Infarctions After Coronary Angiography

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