Stroke in coronary artery bypass graft surgery: an analysis of the CASS experience

Robert L. Frye, Richard Kronmal, Hartzell V Schaff, William O. Myers, Bernard J. Gersh, Participants in the Coronary Artery Surgery Study the Participants in the Coronary Artery Surgery Study

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65 Scopus citations

Abstract

An analysis of the Coronary Artery Surgery Registry (CASS) was performed to determine the occurrence of stroke after coronary artery bypass surgery in patients entered into the Coronary Artery Surgery Study Registry. Of the 10,098 patients having coronary artery bypass surgery at the Coronary Artery Surgery Study participating sites during the period July 1974 through May 1979, a total of 348 patients (or 3.4%) sustained a stroke during the first year after coronary bypass surgery. Fifty-nine strokes occurred on the day of surgery, and an additional 129 strokes occurred during hospitalization for coronary bypass surgery. Thus, 188 patients (1.9%) of the entire surgical group sustained a stroke during initial hospitalization for coronary artery bypass surgery. Logistic regression analysis was used to predict stroke on the day of surgery, during the hospitalization for surgery, and during the first year after surgery. The most powerful predictors of stroke on the day of coronary artery bypass surgery were: 1) older age (n = < 0.0001); 2) use of α-adrenergic drugs after bypass (n = 0.0001); and 3) longer duration of cardiopulmonary bypass (n = 0.002). For those strokes occurring at least 1 day after coronary artery bypass but during the initial hospitalization, age and duration of cardiopulmonary bypass were the most powerful predictors of stroke. An analysis of predictors of stroke within 1 yr after hospital dismissal for initial coronary bypass surgery revealed that the most powerful predictor was a history of previous cerebrovascular disease (n < 0.0001) and a history of hypertension (n < 0.0001). These data provide a perspective of stroke after coronary bypass surgery and identify predictors of high-risk subgroups of patients for such an event.

Original languageEnglish (US)
Pages (from-to)213-221
Number of pages9
JournalInternational Journal of Cardiology
Volume36
Issue number2
DOIs
StatePublished - 1992

Keywords

  • Coronary artery bypass surgery
  • Coronary Artery Surgery Study Registry
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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