Determinants of Carotid Artery Stenosis in Patients Undergoing Coronary Artery Bypass Grafting – A Logistic Regression Approach

Open Access

Abstract

Background: Extracranial carotid artery stenosis (CAS) is a significant risk factor for perioperative stroke in coronary artery bypass graft (CABG) patients. CAS ≥50% occurs in up to one-third of patients, with severe stenosis (≥70%) in 7–11%. Stroke risk and mortality rise with stenosis severity. Key predictors include advanced age, hypertension, prior stroke, peripheral vascular disease, and left main coronary disease. CAS increases the risk of cerebral hypoperfusion and postoperative neurological complications. Preoperative screening of high-risk patients is recommended to enable timely management, reduce perioperative stroke, and improve CABG outcomes. Methods & Materials: This hospital-based study at BSMMU, Dhaka (March 2017–Feb 2019) included 112 CABG patients, grouped by carotid artery stenosis (CAS) status. Demographic, clinical, and comorbidity data were collected, and preoperative carotid Doppler assessed CAS. Data analysis used SPSS v23 with Chi-square/Fisher’s tests and multivariate logistic regression to identify independent CAS predictors (p<0.05). Results: Among 112 CABG patients, those with CAS were older and had higher rates of hypertension, diabetes, and smoking. Logistic regression identified age, smoking, hypertension, and diabetes as independent risk factors for CAS, while LMCAD and CKD were not significant predictors. Conclusion: Age, smoking, hypertension, and diabetes were independent predictors of carotid artery stenosis (CAS) in CABG patients, while LMCAD and CKD were not. These findings emphasize the need for targeted preoperative CAS screening in older, hypertensive, diabetic, and smoking patients to reduce perioperative cerebrovascular complications.