Hammad Azam, Allah Baksh, Zaigham Rasool Khalid.
Stroke after coronary artery bypass grafting; a single centre study.
Pak Heart J Jan ;50(3):175-9.

Objective: To determine the frequency of perioperative stroke after conventional coronary artery bypass grafting. Methodology: This cross sectional study included the data of patients who underwent conventional on-pump coronary artery bypass grafting (CABG) from January to December 2014 at Cardiac Surgery Unit of Chaudhry Pervaiz Elahi Institute of Cardiology. Patients who underwent valvular operations, off-pump CABG, root replacement and those who failed to wean off from cardiopulmonary bypass were excluded. Occurrence of any new permanent or transient neurologic deficit was defined as perioperative stroke. Multi-nomial logistic regression was applied to determine the effect of risk factors on perioperative stroke. Odds ratio and p value were calculated for each variable. p<0.05 was taken as significant. Result: Out of 500 patients, 86% patients were males. The incidence of perioperative stroke was 1.8%. The need of high dose of inotropic support on weaning from CPB and post-operative atrial fibrillation were the strongest predictor of post-operative stroke with odds ratio of 9.50 (0.75-119.7) and 5.43 (1.42-20.77) respectively. The odds of having stroke after CPB in hypertensive patients was 5.43 (1.42-20.77), 2.27 (0.23-22.53) in hyper-cholestremic, 1.13 (0.24-5.25) in patients with family history of IHD, and 1.06 (0.25-4.55) indiabetic patients. Conclusion: Post-operative atrial fibrillation and requirement of high dose inotropic support after weaning from CABG are the strongest predictor of perioperative stroke.

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