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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). Design : 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. Conclusion : 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.