Association Between Intraoperative Hypotension During Off-pump Coronary Artery Bypass Grafting and Postoperative Ischemic Stroke
10.3969/j.issn.1000-3614.2025.11.010
- VernacularTitle:非体外循环冠状动脉旁路移植术中低血压与术后早期缺血性脑卒中的相关性
- Author:
Junping DU
1
;
Dou DOU
1
;
Fuxia YAN
1
;
Zhiyan HAN
1
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 麻醉中心,北京 100037
- Publication Type:Journal Article
- Keywords:
off-pump coronary artery bypass grafting;
general anesthesia;
intraoperative hypotension;
ischemic stroke
- From:
Chinese Circulation Journal
2025;40(11):1117-1122
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:This study aims to investigate the association between intraoperative hypotension(IOH)and postoperative stroke within 7 days following off-pump coronary artery bypass grafting(OPCABG).Methods:A retrospective analysis was conducted on 1 006 patients who underwent elective OPCABG at our hospital between April 2023 and April 2024.According to whether the mean arterial pressure(MAP)decreased to 55 mmHg during the operation and the corresponding time,the patients were divided into three groups:non-hypotension group(n=632),short-term hypotension group(MAP<55 mmHg cumulative time<15 minutes,n=279)and long-term hypotension group(MAP<55 mmHg cumulative time≥15 minutes,n=95).To study the effect of the cumulative duration of hypotension on cerebral perfusion when MAP<55 mmHg was used as the critical value of hypotension.The primary outcome measure was early ischemic stroke within 7 days after surgery.Results:The incidence of early postoperative ischemic stroke was 0.6%,3.6%and 1.1%in the non-hypotension group,short-term hypotension group and long-term hypotension group,respectively.Compared with the non-hypotension group,the incidence of early postoperative ischemic stroke in the short-term hypotension group was significantly higher(P<0.0167).Multivariate logistic regression analysis showed that compared with the non-hypotension group,short-term IOH(OR=6.535,95%CI:1.980-21.574,P=0.002)and preoperative serum creatinine level(OR=1.023,95%CI:1.008-1.039,P=0.002)were associated with the occurrence of ischemic stroke within 7 days after operation,long-term IOH was not associated with ischemic stroke within 7 days after operation(OR=1.691,95%CI:0.178-16.029,P=0.647).Conclusions:The occurrence of ischemic stroke after off-pump coronary artery bypass grafting is related to short-term IOH,but not to long-term IOH.
