The risk of stroke following coronary revascularization -- a population-based long-term follow-up study.
OBJECTIVE
To study the incidence and risk factors of stroke after coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA).


METHODS
During 1983-1992, coronary revascularization procedures (n = 2160) were recorded in patients aged 35-64 years as part of the population-based FINMONICA Myocardial Infarction Register. The FINMONICA Stroke Register and National Hospital Discharge Register were used to ascertain subsequent stroke events in such patients.


RESULTS
During the average follow-up of 5.83 years, 155 patients (7.2%) had a stroke. The cumulative incidence of stroke was 1.55% in the first year after revascularization and varied between 0.8 and 1.4% during subsequent years. In Cox proportional hazard models the relative risk of stroke was 3.01 (p = 0.0007) for a previous stroke, 2.61 (p = 0.0001) for diabetes mellitus, 2.15 (p = 0.007) for low income (compared with high income), 2.06 (p = 0.03) for male sex, and 1.43 (p = 0.02) for a 10-year increment in age.


CONCLUSIONS
The incidence of stroke during the first year after revascularization was five times higher than among the age- and sex-matched general population. Patients with a previous stroke, diabetes mellitus, advanced age, male sex and low socioeconomic status need special attention because of increased risk of stroke after CABG or PTCA.
Kaarisalo
Minna M
MM
Department of Neurology, University of Turku, Turku, Finland. minna.kaarisalo@utu.fi
Immonen-Räihä
Pirjo
P
Marttila
Reijo J
RJ
Salomaa
Veikko
V
Torppa
Jorma
J
Tuomilehto
Jaakko
J
D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D048909:Diabetes Complications; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D020521:Stroke / Q000150:complications* / Q000453:epidemiology* / Q000401:mortality; D016019:Survival Analysis