title: Patients with severe asymptomatic carotid artery stenosis do not have a higher risk of stroke and mortality after coronary artery bypass surgery.
abstract: OBJECTIVE
  Stroke development is a major concern in patients undergoing coronary artery bypass grafting (CABG). Whether asymptomatic severe carotid artery stenosis (CAS) contributes to the development of stroke and mortality in such patients remains uncertain.
  
  
  METHODS
  A retrospective analysis of 878 consecutive patients with documented carotid duplex ultrasound who underwent isolated CABG in our institution from January 2003 to December 2009 was performed. Patients with severe CAS (n=117) were compared with those without severe CAS (n=761) to assess the rates of stroke and mortality during hospitalization for CABG. The 30-day mortality rate was also assessed.
  
  
  RESULTS
  Patients with severe CAS were older and had a higher prevalence of peripheral arterial disease and heart failure. Patients with severe CAS had similar rates of in-hospital stroke (3.4% versus 3.6%; P=1.0) and mortality (3.4% versus 4.2%; P=1.0) compared with patients without severe CAS. The 30-day rate of mortality was also similar between the 2 cohorts (3.4% versus 2.9%; P=0.51).
  
  
  CONCLUSIONS
  Severe CAS alone is not a risk factor for stroke or mortality in patients undergoing CABG. The decision to perform carotid imaging and subsequent revascularization in association with CABG must be individualized and based on clinical judgment.
authors.affiliation: Department of Cardiothoracic Surgery, Washington Hospital Center, 110 Irving St NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Mahmoudi
authors.forename: Peter C
authors.initials: PC
authors.lastname: Hill
authors.forename: Zhenyi
authors.initials: Z
authors.lastname: Xue
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.forename: Gholam
authors.initials: G
authors.lastname: Ali
authors.forename: Steven W
authors.initials: SW
authors.lastname: Boyce
authors.forename: Ammar S
authors.initials: AS
authors.lastname: Bafi
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Corso
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000401:mortality / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D016896:Treatment Outcome