Risk factors of perioperative stroke in patients with coronary heart disease complicated with carotid artery stenosis

Abstract

Objective To study the incidence and risk factors of perioperative stroke in patients with coronary heart disease complicated with carotid artery stenosis during coronary artery bypass grafting (CABG). Methods One hundred and twenty-four patients with coronary heart disease complicated with carotid artery stenosis admitted to Henan Provincial People’s Hospital from January 2017 to December 2017 were selected. All patients were treated by CABG but without carotid endarterectomy or carotid artery stent implantation at the same time. According to the results of preoperative color Doppler echocardiography, patients were divided into mild stenosis group (unilateral or bilateral internal carotid artery stenosis <50%, n=97) and moderate-severe stenosis group (unilateral or bilateral internal carotid artery stenosis ≥50%, n=27). The perioperative stroke incidences were compared between the two groups, and multivariate logistic regression was used to analyze the risk factors for stroke during perioperative period. Results There was no significant difference in the general data between the two groups (P>0.05). The incidence of perioperative stroke in the moderate-severe stenosis group (18.5%, 5/27) was higher than that in the mild stenosis group (3.01%, 3/97), P<0.05. Multivariate logistic regression analysis showed that moderate-severe stenosis of the carotid artery was an independent risk factor for perioperative stroke in patients with CABG (P<0.05). Conclusions Moderate to severe stenosis in unilateral or bilateral carotid arteries can increase the risk of stroke during perioperative period of CABG. The carotid artery revascularization should be performed in CABG, if indicated, to reduce the incidence of stroke. Key words: Coronary disease; Carotid artery stenosis; Coronary artery bypass grafting; Complications; Stroke