| Gender differences in stroke risk among the elderly after coronary artery surgery. | |
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MedLine Citation:
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PMID: 17456646 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Previous studies have shown that women are at higher risk than men for stroke after coronary artery bypass graft (CABG) surgery, but gender differences in systemic atherosclerosis have not been studied adequately. We investigated gender differences in the incidence of craniocervical and ascending aortic atherosclerosis and other risk factors for stroke in elderly patients (age > or =60 yr) undergoing CABG surgery. METHODS: Data were prospectively collected on 720 patients (31.8% women) undergoing CABG surgery. All patients underwent preoperative brain magnetic resonance imaging and angiography to assess for prior cerebral infarctions, carotid artery stenosis, and intracranial arterial stenosis. Epiaortic ultrasound was performed at the time of surgery to assess for atherosclerosis of the ascending aorta. Cognitive status was measured using the Hasegawa-dementia score in all patients before surgery and on the seventh postoperative day. RESULTS: Women were older and had more hypertension and intracranial arterial stenosis than did men. Men had significantly higher rates of hyperlipidemia, peripheral vascular disease, abdominal aortic aneurysm, smoking history, severe carotid artery stenosis, and severe aortic atherosclerosis than did women. Although there were no differences in prior cerebral infarction or preoperative cognitive impairment, the rate of perioperative stroke was marginally higher in men than in women (3.9% vs 1.3%, P = 0.066). Univariate predictors of perioperative stroke were prior cerebral infarctions, ascending aortic atherosclerosis, preexisting cognitive impairment, and peripheral vascular disease. Stepwise logistic regression analysis demonstrated that significant independent predictors of perioperative stroke were prior cerebral infarctions and aortic atherosclerosis. CONCLUSIONS: These data suggest that men are more likely than women to have risk factors for stroke, including severe carotid artery stenosis, severe aortic atherosclerosis, and peripheral vascular disease. The rates of prior cerebral infarction and preoperative cognitive impairment were similar between genders. |
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Authors:
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Tomoko Goto; Tomoko Baba; Asuka Ito; Kengo Maekawa; Takaaki Koshiji |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 104 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2007 May |
Date Detail:
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Created Date: 2007-04-25 Completed Date: 2007-05-24 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 1016-22, tables of contents Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Kumamoto Chuo Hospital, Kumamoto, Japan. togoto@bronze.ocn.ne.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Atherosclerosis / complications, epidemiology Cardiovascular Surgical Procedures* / adverse effects Coronary Artery Disease / complications, epidemiology*, surgery* Female Humans Male Middle Aged Prospective Studies Risk Factors Sex Characteristics* Stroke / epidemiology*, etiology |
| Comments/Corrections | |
Comment In:
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Anesth Analg. 2007 May;104(5):1012-4
[PMID:
17456645
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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