Consequence of Ischemic Stroke after Coronary Surgery with Cardiopulmonary Bypass According to Stroke Subtypes

Abstract Introduction: The aim of this study was to determine the outcomes of patients developing ischemic stroke after coronary artery bypass grafting (CABG). Methods: From March 2012 to January 2017, 5380 consecutive patients undergoing elective coronary surgery were analyzed. Ninety-five patients who developed ischemic strokes after on-pump coronary surgery were included in the study, retrospectively. The cohort was divided into four subgroups [total anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), posterior circulation infarction (POCI), and lacunar infarction (LACI)] according to the Oxfordshire Community Stroke Project (OCSP) classification. The primary endpoints were in-hospital mortality, total mortality, and survival analysis over an average of 30 months of follow-up. The secondary endpoints were the extent of disability and dependency according to modified Rankin Scale (mRS). Results: The incidence of stroke was 1.76% (n=95). The median age was 62.03±10.06 years and 68 (71.6%) patients were male. The groups were as follows: TACI (n=17, 17.9%), PACI (n=47, 49.5%), POCI (n=20, 21.1%), and LACI (n=11, 11.6%). Twenty-eight (29.5%) patients died in hospital and 34 (35.8%) deaths occurred. The overall mortality rate of the TACI group was significantly higher than that of the LACI group (64.7% vs. 27.3%, P=0.041). The mean mRS score of the TACI group was significantly higher than that of the other groups (P=0.003). Conclusion: Patients in the TACI group had higher in-hospital and cumulative mortality rates and higher mRS scores. We believe that use of the OCSP classification and the mRS may render it possible to predict the outcomes of stroke after coronary surgery.

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Main Authors: Aldag,Mustafa, Kocaaslan,Cemal, Bademci,Mehmet Senel, Yildiz,Zeynep, Kahraman,Aydin, Oztekin,Ahmet, Yilmaz,Mehmet, Kehlibar,Tamer, Ketenci,Bulend, Aydin,Ebuzer
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Cirurgia Cardiovascular 2018
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000500462
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spelling oai:scielo:S0102-763820180005004622019-02-21Consequence of Ischemic Stroke after Coronary Surgery with Cardiopulmonary Bypass According to Stroke SubtypesAldag,MustafaKocaaslan,CemalBademci,Mehmet SenelYildiz,ZeynepKahraman,AydinOztekin,AhmetYilmaz,MehmetKehlibar,TamerKetenci,BulendAydin,Ebuzer Stroke Coronary Artery Bypass Coronary Artery Bypass/Adverse Effects Cardiopulmonary Bypass Abstract Introduction: The aim of this study was to determine the outcomes of patients developing ischemic stroke after coronary artery bypass grafting (CABG). Methods: From March 2012 to January 2017, 5380 consecutive patients undergoing elective coronary surgery were analyzed. Ninety-five patients who developed ischemic strokes after on-pump coronary surgery were included in the study, retrospectively. The cohort was divided into four subgroups [total anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), posterior circulation infarction (POCI), and lacunar infarction (LACI)] according to the Oxfordshire Community Stroke Project (OCSP) classification. The primary endpoints were in-hospital mortality, total mortality, and survival analysis over an average of 30 months of follow-up. The secondary endpoints were the extent of disability and dependency according to modified Rankin Scale (mRS). Results: The incidence of stroke was 1.76% (n=95). The median age was 62.03±10.06 years and 68 (71.6%) patients were male. The groups were as follows: TACI (n=17, 17.9%), PACI (n=47, 49.5%), POCI (n=20, 21.1%), and LACI (n=11, 11.6%). Twenty-eight (29.5%) patients died in hospital and 34 (35.8%) deaths occurred. The overall mortality rate of the TACI group was significantly higher than that of the LACI group (64.7% vs. 27.3%, P=0.041). The mean mRS score of the TACI group was significantly higher than that of the other groups (P=0.003). Conclusion: Patients in the TACI group had higher in-hospital and cumulative mortality rates and higher mRS scores. We believe that use of the OCSP classification and the mRS may render it possible to predict the outcomes of stroke after coronary surgery.info:eu-repo/semantics/openAccessSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery v.33 n.5 20182018-10-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000500462en10.21470/1678-9741-2018-0086
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libraryname SciELO
language English
format Digital
author Aldag,Mustafa
Kocaaslan,Cemal
Bademci,Mehmet Senel
Yildiz,Zeynep
Kahraman,Aydin
Oztekin,Ahmet
Yilmaz,Mehmet
Kehlibar,Tamer
Ketenci,Bulend
Aydin,Ebuzer
spellingShingle Aldag,Mustafa
Kocaaslan,Cemal
Bademci,Mehmet Senel
Yildiz,Zeynep
Kahraman,Aydin
Oztekin,Ahmet
Yilmaz,Mehmet
Kehlibar,Tamer
Ketenci,Bulend
Aydin,Ebuzer
Consequence of Ischemic Stroke after Coronary Surgery with Cardiopulmonary Bypass According to Stroke Subtypes
author_facet Aldag,Mustafa
Kocaaslan,Cemal
Bademci,Mehmet Senel
Yildiz,Zeynep
Kahraman,Aydin
Oztekin,Ahmet
Yilmaz,Mehmet
Kehlibar,Tamer
Ketenci,Bulend
Aydin,Ebuzer
author_sort Aldag,Mustafa
title Consequence of Ischemic Stroke after Coronary Surgery with Cardiopulmonary Bypass According to Stroke Subtypes
title_short Consequence of Ischemic Stroke after Coronary Surgery with Cardiopulmonary Bypass According to Stroke Subtypes
title_full Consequence of Ischemic Stroke after Coronary Surgery with Cardiopulmonary Bypass According to Stroke Subtypes
title_fullStr Consequence of Ischemic Stroke after Coronary Surgery with Cardiopulmonary Bypass According to Stroke Subtypes
title_full_unstemmed Consequence of Ischemic Stroke after Coronary Surgery with Cardiopulmonary Bypass According to Stroke Subtypes
title_sort consequence of ischemic stroke after coronary surgery with cardiopulmonary bypass according to stroke subtypes
description Abstract Introduction: The aim of this study was to determine the outcomes of patients developing ischemic stroke after coronary artery bypass grafting (CABG). Methods: From March 2012 to January 2017, 5380 consecutive patients undergoing elective coronary surgery were analyzed. Ninety-five patients who developed ischemic strokes after on-pump coronary surgery were included in the study, retrospectively. The cohort was divided into four subgroups [total anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), posterior circulation infarction (POCI), and lacunar infarction (LACI)] according to the Oxfordshire Community Stroke Project (OCSP) classification. The primary endpoints were in-hospital mortality, total mortality, and survival analysis over an average of 30 months of follow-up. The secondary endpoints were the extent of disability and dependency according to modified Rankin Scale (mRS). Results: The incidence of stroke was 1.76% (n=95). The median age was 62.03±10.06 years and 68 (71.6%) patients were male. The groups were as follows: TACI (n=17, 17.9%), PACI (n=47, 49.5%), POCI (n=20, 21.1%), and LACI (n=11, 11.6%). Twenty-eight (29.5%) patients died in hospital and 34 (35.8%) deaths occurred. The overall mortality rate of the TACI group was significantly higher than that of the LACI group (64.7% vs. 27.3%, P=0.041). The mean mRS score of the TACI group was significantly higher than that of the other groups (P=0.003). Conclusion: Patients in the TACI group had higher in-hospital and cumulative mortality rates and higher mRS scores. We believe that use of the OCSP classification and the mRS may render it possible to predict the outcomes of stroke after coronary surgery.
publisher Sociedade Brasileira de Cirurgia Cardiovascular
publishDate 2018
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000500462
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