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Abstracts of the 5th International Conference on Stroke and 2nd Conference of the Mediterranean Stroke Society

Introduction Despite of surgical and medical care improvements, stroke remains one of the most apprehended complications of cardiac surgery. The prevalence of carotid atherosclerotic lesions in patients with coronary artery disease is high. We aimed to study the prevalence and the predictors of asymptomatic cerebrovascular disease in patients undergoing coronary artery bypass surgery (CABG). Methods Initially 557 consecutive patients undergoing CABG were enrolled. Patients with a history of carotid surgery (6 patients) or a history of stroke or TIA (37 patients). A Duplex ultrasound was performed on the remaining 514 patients (mean age 66.7 years). Patients with a 70% or higher artery stenosis were considered as being at high risk of stroke. Results In 38 cases (7.4%) a high risk lesion has been found. Neck pain was more often present but was weak to detect all of them (34.5% vs. 6.8%, P < 0.0001). In a multivariate analysis, the sole independent predictive factors were a history of smoking (OR 4.36, P < 0.0001), hypertension (OR 2.06, P < 0.04) and an abnormal ankle–arm index (OR 1.92, P = 0.05). Conclusion The prevalence of high risk cerebrovascular disease in patients undergoing CABG is important. In addition to the presence of neck pain, smoking, hypertension and abnormal ankle–arm index can help us to select patients requiring Duplex screening.