Prevalence of Carotid Stenosis and Incidence of Ischemic Stroke in Patients Undergoing Non-Coronary Cardiac Surgery

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 34; no. 5; pp. 550 - 559
• Main Authors: Costa, Mario Augusto Cray da, Nadal, João Paulo, Okamoto, Jefferson Matsuiti, Betero, André Luis, Schafranski, Marcelo Derbli, Gomes, Ricardo Zanetti, Reis, Elise Souza Dos Santos
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01.01.2019
• Subjects: Age; Anesthesia; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiac Surgical Procedures; Cardiology; Cardiovascular disease; Carotid arteries; Carotid Stenosis; Chronic obstructive pulmonary disease; Coronary vessels; Diabetes; Ejection fraction; Heart surgery; Hypertension; Original; Patients; Stroke; SURGERY; Valvar Disease; Variables; Brazil; Cardiac Surgical Procedures; Stroke; Carotid Stenosis; Valvar Disease
• ISSN: 1678-9741; 0102-7638; 1678-9741
• DOI: 10.21470/1678-9741-2018-0127

Many publications on coronary surgery and carotid stenosis (CS) can be found, but we do not have enough information about the relationship between ischemic stroke, CS and non-coronary cardiac surgery. To evaluate the incidence and risk factors associated with the stroke and CS ≥50% in patients undergoing non-coronary surgeries. We assessed 241 patients, aged 40 years or older, between 2009 and 2016, operated in Santa Casa de Misericórdia de Ponta Grossa-PR, Brazil. We perform carotid Doppler in patients 40 years of age or older before any cardiac surgery as a routine. The incidence and possible risk factors for CS ≥50% and perioperative stroke were analyzed by univariate statistical analysis. 11 patients (4.56%) presented perioperative stroke. The risk factor for stroke was CS ≥50%: OR=5.3750 (1.2909-22.3805), P=0.0208. Eighteen patients (7.46%) had CS ≥50% and their risk factors were extracardiac arteriopathy: OR=18.6607 (6.3644-54.7143), P<0.0001; COPD: OR=3.9040 (1.4491-10.5179), P=0.0071; diabetes mellitus: OR=2.9844 (1.0453-8.5204), P=0.0411; recent myocardial infarction: OR=13.8125 (1.8239-104.6052), P=0.0110; EuroSCORE II higher P=0.0056. The incidences of stroke and CS ≥50% were 4.56% and 7.46%, respectively. The risk factor for stroke was CS ≥50% and for CS ≥50% were extracardiac arteriopathy, COPD, diabetes mellitus, recent myocardial infarction and higher EuroSCORE II.