Off-pump coronary artery bypass surgery (CABG) has not abolished the risk of postoperative
stroke and
delirium seen for on-pump CABG. Advanced arteriosclerotic changes are common in both on-pump and off-pump CABG. We sought to analyze if advanced arteriosclerotic changes are risk factors of
stroke or
transient ischemic attack (TIA), and
delirium after off-pump CABG. Patients undergoing off-pump CABG between 2001 and 2005 were reviewed using medical records (n=685). Potential risk factors of postoperative
stroke and
delirium were identified from previous studies. Further, variables retrieved from carotid artery duplex scanning as indices of advanced
arteriosclerosis, were examined. The incidences of postoperative
stroke/TIA and
delirium after off-pump CABG were 2.6% (n=18) and 16.4% (n=112), respectively.
Carotid artery stenosis >50% was a significant risk factor of
stroke or TIA (P=0.02) as well as
delirium (P=0.04) after off-pump CABG. A history of
atrial fibrillation (AF) (P=0.037) or
diabetes mellitus (P=0.041) was a risk factors of postoperative
stroke or TIA. In contrast, age over 75 years (P=0.006),
creatinine >1.3 mg/dl (99 μmol/l) (P=0.011), a history of
hypertension (P=0.001), past history of AF (P=0.024), and smoking (P=0.048) were significant risk factors of
postoperative delirium.