POST-CORONARY ARTERY BYPASS GRAFT STROKE AND ITS RELATED RISK FACTORS

Abstract  INTRODUCTION: Cerebrovascular accident (CVA) or stroke remains a devastating complication of cardiac surgical procedures, especially coronary artery bypass graft (CABG) despite advances in perioperative monitoring and management. An individual's risk of stroke is based in part on preoperative characteristics, but also on intra- and postoperative factors. The purpose of this study was to determine the prevalence and predictors of stroke in a large group of patients undergoing cardiac surgery. methods: Data were collected on ۱۴۶۷ patients who underwent CABG at Chamran Heart Center from ۱۹۹۵ to ۲۰۰۳. Stroke was defined as "a new focal neurological deficit which appears and is still at least partially evident more than ۲۴ hours after its onset". Logistic regression identified significant predictors of stroke. results: Among the preoperative and postoperative factors, significant correlates of stroke included chronic renal insufficiency (P=۰.۰۰۰۱), hypertension (P=۰.۰۰۰۱), diabetes (P=۰.۰۰۰۱), and atrial fibrillation (P=۰.۰۰۰۱). However, stroke had no significant correlation with sex (P=۰.۰۵۴), age (P=۰.۲۸), severe LV failure (P=۰.۰۶۲), history of CVA (P=۰.۷۲۳) or shock state (P=۰.۸۰۲). Discussion: Neurologic complications after cardiac surgical procedures remain a relatively common problem despite improvements in anesthetic and surgical techniques, as well as in perioperative monitoring and management. Increased stroke risk can be predicted by preoperative and postoperative clinical factors.Keywords • Stroke • Cerebrovascular accident • Coronary artery bypass graft (CABG)