• Vincent J Kroeze, Jules R Olsthoorn, van StratenAlbert H MAHMDepartment of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands., Anouk Princee, and Mohamed A Soliman-Hamad.
• Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
• J. Cardiothorac. Vasc. Anesth. 2023 Aug 1; 37 (8): 139714021397-1402.

ObjectiveStroke remains a devastating complication after cardiac surgical procedures despite perioperative monitoring and management advances. This study aimed to determine the predictors of stroke in a large, contemporary coronary artery surgery population.DesignPatient data were analyzed retrospectively.SettingThis single-center study was performed in the Catharina Hospital (Eindhoven).ParticipantsAll patients who underwent isolated coronary artery bypass grafting (CABG) between January 1998 and February 2019 were included.InterventionsIsolated CABG.Measurements And Main ResultsThe primary endpoint was a postoperative stroke, defined according to the international updated definition for stroke. Logistic regression was performed to retrieve variables associated with postoperative stroke. A total of 20,582 patients underwent CABG during the period of the study. Stroke was observed in 142 patients (0.7%), of which 75 (52.8%) occurred during the first 72 hours. The incidence of postoperative stroke declined over the years. A significantly higher 30-day mortality rate was seen in patients with stroke (20.4%) compared with 1.8% in the rest of the population; p < 0.001. Multivariate logistic regression analysis showed age, peripheral arterial disease, reexploration for bleeding, perioperative myocardial infarction, and year of surgery as independent predictors for stroke. Patients with postoperative stroke had worse long-term survival (log-rank p < 0.001). Cox regression analysis revealed postoperative stroke (odds ratio 2.13 [1.73-2.64)) as an independent predictor of late mortality.ConclusionsStroke after CABG is associated with high early and late mortality. Age, peripheral vascular disease, and the year of surgery were associated with postoperative stroke.Copyright © 2023 Elsevier Inc. All rights reserved.

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