Abstract 4360441: Predictors of Stroke Risk in Patients Undergoing Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis

Abstract

Background: Coronary artery bypass grafting (CABG) carries a 1–5% risk of stroke, a serious complication linked to increased mortality and healthcare burden. Individual patient and procedural factors such as age, comorbidities, and aortic manipulation influence stroke risk. This meta-analysis aims to evaluate predictors of stroke risk in patients undergoing CABG. Methods: A comprehensive search was conducted across major databases to identify studies assessing the predictive factors for stroke risk in patients undergoing CABG. Odds ratios (OR) with 95% CIs were pooled using a random effects model, and all analyses were performed using R studio version 4.4.3. Results: A total of 16 studies comprising 123,535 patients were included. Atrial fibrillation, female sex, diabetes mellitus, heart failure, hypertension, cardiovascular disease, peripheral arterial disease, renal failure, carotid bruits, and previous stroke were all significantly associated with an increased risk of stroke, with odds ratios (ORs) ranging from 1.33 to 4.94. Previous strokes (OR: 3.08; 95% CI: 1.98, 4.80) and carotid bruits (OR: 4.94; 95% CI: 2.49, 9.85) showed the strongest associations. However, no significant associations were observed for angina (OR: 1.19; 95% CI: 0.59,2.39), chronic obstructive pulmonary disease (OR: 1.41; 95% CI: 0.75, 2.63), myocardial infarction (OR: 1.19; 95% CI: 0.76, 1.87), mitral regurgitation (OR: 1.18; 95% CI: 0.76, 1.84), or previous thoracic surgery (OR: 1.26; 95% CI: 0.59, 2.69). Despite varying degrees of heterogeneity across outcomes, leave-one-out analyses consistently confirmed the robustness of these results, indicating that no individual study significantly altered the overall findings. Conclusion: This meta-analysis identifies key predictors of stroke following CABG, with previous strokes and carotid bruits showing the strongest associations. Recognizing these risk factors enables targeted prevention and management strategies, potentially reducing stroke incidence and improving patient outcomes.