Does Warfarin Help Prevent Ischemic Stroke in Patients Presenting with Post Coronary Bypass Paroxysmal Atrial Fibrillation?
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- Hata Mitsumasa
- Department of Cardiovascular Surgery, Nihon University Nerima Hikarigaoka Hospital, Tokyo, Japan
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- Akiyama Kenji
- Department of Cardiovascular Surgery, Nihon University Nerima Hikarigaoka Hospital, Tokyo, Japan
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- Wakui Shinji
- Department of Cardiovascular Surgery, Nihon University Nerima Hikarigaoka Hospital, Tokyo, Japan
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- Takasaka Ayako
- Department of Cardiovascular Surgery, Nihon University Nerima Hikarigaoka Hospital, Tokyo, Japan
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- Sezai Akira
- Department of Cardiovascular, Respiratory, and General Surgery, Nihon University School of Medicine, Tokyo, Japan
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- Shiono Motomi
- Department of Cardiovascular, Respiratory, and General Surgery, Nihon University School of Medicine, Tokyo, Japan
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Abstract
Purpose: This study examines the efficacy of warfarin in preventing ischemic stroke due to paroxysmal atrial fibrillation (PAF) after coronary artery bypass grafting (CABG). <br>Methods: Postoperative PAF occurred in 151(33.5%) of 447 patients undergoing conventional CABG. The patients were divided into two groups: group I consisting of 93 patients administered two types of antiplatelet agents and group II consisting of 58 patients treated with a single antiplatelet agent and warfarin. We compared the two groups in terms of CHADS2 score, incidence of ischemic stroke, and independent risk for stroke associated with post-CABG PAF.<br>Results: The group I CHADS2 score (2.24 ±1.67) was significantly lower than the group II score (2.64 ± 1.22), p = 0.0452. However, 12 patients in group I (12.9%) suffered postoperative ischemic stroke, a rate significantly higher than that of group II (1 patient, 1.7%; p = 0.0173). Any recurrence of PAF or atrial fibrillation with bradycardia was assessed at the time of stroke onset. Logistic regression analysis showed that the absence of warfarin therapy constituted a risk factor for post-CABG stroke associated with PAF (Odds 13.04, p = 0.027).<br>Conclusion: Warfarin therapy administered concomitantly with an antiplatelet agent dramatically reduced the incidence of ischemic stroke associated with postoperative PAF.
Journal
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- Annals of Thoracic and Cardiovascular Surgery
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Annals of Thoracic and Cardiovascular Surgery 19 (3), 207-211, 2013
The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery
