Use of CHA2DS2-VASc score to predict the risk of ischemic stroke and mortality in patients who underwent coronary artery bypass grafting surgery: a retrospective cohort study

B. Düzel

Department of Cardiology, Mersin City Training and Research Hospital, Mersin, Turkey. drbarisss@hotmail.com

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• Cardiac surgery
• Cardiology

OBJECTIVE: Ischemic stroke and postoperative atrial fibrillation (POAF) are frequently seen after coronary artery bypass grafting (CABG). CHA2DS2-VASc scoring system is used to predict ischemic stroke and POAF. This study aimed to evaluate CHA2DS2-VASc scores in predicting ischemic stroke after CABG and analyze the effect of POAF on the relationship between CHA2DS2-VASc scores and ischemic stroke.

PATIENTS AND METHODS: Demographic and clinical characteristics of patients who underwent CABG were retrospectively recorded. CHA2DS2-VASc score was calculated for each patient and stratified into low- and high-risk groups. The heart rhythm of the patients was monitored during in-hospital follow-up and ischemic stroke was evaluated. Ischemic stroke and POAF were the primary and secondary outcomes.

RESULTS: There were 383 patients (mean age of 63.1 ± 10.4 years). Ischemic stroke developed in eight (2.1%) patients. There were 248 (64.8%) high-risk patients with CHA2DS2-VASc scores. Patients with ischemic stroke were significantly older (p = 0.021) and had higher CHA2DS2-VASc scores (p < 0.001). Low and high-risk groups did not reveal any significant difference for ischemic stroke (p = 0.055). There were 56 (14.7%) patients with POAF. The relationship between CHA2DS2-VASc scores and ischemic stroke was not affected by POAF (p = 0.739). CHA2DS2-VASc scores of ≥3 predicted ischemic stroke (p < 0.001) with 100% sensitivity and 64.5% specificity.

CONCLUSIONS: Ischemic stroke was associated with a higher mortality risk after CABG. Higher CHA2DS2-VASc scores were associated with higher ischemic stroke risk. POAF did not significantly affect the relationship between CHA2DS2-VASc scores and ischemic stroke. CHA2DS2-VASc score can be used to predict ischemic stroke and mortality following CABG.

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