Predictors of perioperative stroke include prior stroke, warfarin use, surgery outside U.S., Canada
THURSDAY, May 28, 2015 (HealthDay News) — For patients with diabetes mellitus undergoing multivessel coronary artery bypass grafting (CABG), predictors of stroke include previous stroke, warfarin use, and surgery outside the United States or Canada, according to research published in the May 15 issue of The American Journal of Cardiology.
Michael J. Domanski, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues examined demographic and clinical variables associated with perioperative and late stroke in patients with diabetes mellitus after CABG. Predictors of stroke after CABG were assessed in patients from the Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease randomized trial.
The researchers found that previous stroke, warfarin use, and surgery outside the United States or Canada were independent predictors for perioperative stroke (odds ratios, 6.96, 10.26, and 9.81, respectively). Renal insufficiency (hazard ratio, 3.57), baseline low-density lipoprotein ≥105 mg/dL (hazard ratio, 3.28), and baseline diastolic blood pressure (hazard ratio, 0.95 for each 1 mm Hg increase) were independent predictors for late stroke. No overlap was seen for predictors of perioperative versus late stroke.
“In conclusion, late post-CABG strokes were associated with well-described risk factors,” the authors write. “Nearly half of the strokes were perioperative. Independent risk factors for perioperative stroke: previous stroke, previous warfarin use, and CABG performed outside the United States or Canada.”
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