Objective: To determine the influence of carotid artery plaque (CAP) morphology on perioperative stroke in coronary artery bypass grafting (CABG).
Patients and methods: Ninety-three patient undergoing CABG were studied. CAPs and other lesions including intima-media thickness (IMT) and stenosis were examined by using ultrasound imaging. CAPs were morphologically classified as either homogeneous (HmP) or heterogeneous (HtP).
Results: Mean and max IMT were 1.26 +/- 0.15 and 2.44 +/- 0.76 mm. Mean total plaque score was 15.75 +/- 6.82. HmP and HtP were seen in 80 (86.0%) and 54 (58.1%) patients. Stenosis greater than 50% was found in 22 (23.7%) patients. HtP was significantly associated with age (p<0.05), diabetes and severity of coronary artery disease (p<0.01) and stenosis was associated with diabetes and history of cerebrovascular events (p <0.05). Late postoperative stroke occurred in 3 (3.2%) patients during hospitalization. One of them had 90% stenosis in the carotid artery. The others had no carotid stenosis. In all of the 3, the predominant plaques were heterogeneous.
Conclusion: CAP morphology in patients undergoing CABG was detailed. As well as stenotic lesion, plaque heterogeneity may be a risk factor for perioperative stroke. Diabetes is associated with severity of both plaque heterogeneity and stenosis.