Heart Surgery Found Riskier for Stroke Victims

Patients who have suffered a stroke are 14 times more likely to have a new stroke just after a heart bypass surgery than people who have other cardiovascular problems, a new study shows.

The findings could help doctors predict which patients are at highest risk for a stroke complication during or after surgery, and may also help to identify ways to lower the risk with some patients, researchers said.

The study identified other groups at higher risk for stroke after a bypass. These included women, who had triple the risk, and patients with severe atherosclerosis--hardened fatty buildup known as plaque--inside their aortic artery, who had double the risk of a stroke.

“Stroke is one of the most devastating complications of heart surgery,” said Charles Hogue, an associate professor of anesthesiology and chief of cardio-thoracic anesthesia at the Washington University and Barnes-Jewish Hospital in St. Louis. “Because we were better able to adjust for this risk factor . . . other risk factors might take on a new meaning.”

Researchers looked at the medical records of nearly 3,000 men and women who had had bypass surgery, valve surgery, or both, for the study, which appears in the Aug. 10 issue of the American Heart Assn.’s journal Circulation. The study confirms earlier stroke risk factor findings.

Patients with diabetes or a condition called atrial fibrillation were at higher risk for post-surgical stroke, as were patients who had surgeries that took longer. Age was not a risk factor, the team said.

Still, the overall incidence of stroke after a bypass is low, and only 1.8% of the patients in the study had problems, Hogue said.

“The benefits of heart surgery, for most patients, outweigh the risks,” he said. “The surgery prolongs life.”