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.
Department of Neurology, University of Turku, Turku, Finland. minna.kaarisalo@utu.fi
Minna M
MM
Kaarisalo
Pirjo
P
Immonen-Räihä
Reijo J
RJ
Marttila
Veikko
V
Salomaa
Jorma
J
Torppa
Jaakko
J
Tuomilehto
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