Value of echocardiography for stroke and mortality prediction following coronary artery bypass grafting

Orit Kluck, Marius Berman, Alon Stamler, Gideon Sahar, Alexander Kogan, Eyal Porat, Alexander Sagie

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

There are known clinical and laboratory predictors for stroke and death following CABG. The aim of this study was to determine if transthoracic echocardiographic findings prior to CABG have additional predictive value for occurrence of perioperative cerebrovascular accident (CVA) and death. The files of patients who underwent CABG between January 2002 and November 2004, with perioperative echocardiographic assessment were reviewed. Echocardiographic variables examined included LV size, function and hypertrophy, mitral annulus calcification (MAC) and aortic valve calcification (AVC). Patients in whom post-CABG stroke or death was documented were compared with those without these endpoints. Of the 572 patients who met the study criteria, 33 (5.8%) had a neurological event and 26 (4.5%) died, four after a major stroke. One hundred and sixty-seven patients had MAC and 228 AVC. On multivariate analysis, risk factors for stroke were previous stroke (OR=2.91 CI 1.179-7.24; P<0.005), renal failure (OR=2.48 CI 1.039-5.95; P<0.001) and older age (OR=1.60 CI 0.971-2.63; P<0.001); risk factors for death were perioperative insertion of intra-aortic balloon pump (OR=33.7 CI 11.38-100; P<0.001) and peripheral vascular disease (OR=3.89 CI 1.32-11.45; P<0.001). Medically treated dyslipidemia was protective factor. LV hypertrophy significantly predicts stroke post-CABG by univariate analysis (P=0.02). There was no significant correlation between AVC and MAC with stroke, although death was slightly increased in patients with MAC (44% vs. 29.2%, P=0.114).

Original languageEnglish
Pages (from-to)30-34
Number of pages5
JournalInteractive Cardiovascular and Thoracic Surgery
Volume6
Issue number1
DOIs
StatePublished - 1 Feb 2007
Externally publishedYes

Keywords

  • Aortic valve calcification
  • CABG
  • LV mass
  • Mitral annulus calcification
  • Mortality
  • Risk stratification
  • Stroke

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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