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Impact of inhospital stent thrombosis and cerebrovascular accidents on long-term prognosis after percutaneous coronary intervention.
- Source :
-
American heart journal [Am Heart J] 2014 Dec; Vol. 168 (6), pp. 862-8.e1. Date of Electronic Publication: 2014 Sep 16. - Publication Year :
- 2014
-
Abstract
- Background: Inhospital stent thrombosis (ST) and cerebrovascular accidents (CVA) are rare but serious adverse events after percutaneous coronary intervention (PCI). The association of ST or CVA with long-term outcome after PCI remains poorly investigated.<br />Methods: The study included 18,334 consecutive patients who underwent PCI. Patients were divided into 3 groups: the group with ST, the group with CVA, and the group without these events. The primary outcome was all-cause mortality at 3-year follow-up.<br />Results: Inhospital ST or CVA occurred in 59 patients (0.32%) and in 90 patients (0. 49%), respectively. There were 2,149 deaths (11.7%) during the follow-up: 26 deaths among patients with ST, 32 deaths among patients with CVA, and 2,091 deaths among patients without ST or CVA (Kaplan-Meier estimates of 3-year mortality 45.3%, 38.0%, and 12.9%, odds ratio 6.1, 95% CI 3.6-10.2, P < .001 for ST group vs the group without ST or CVA and odds ratio 4.2 [2.7-6.6], P < .001 for CVA group vs the group without ST or CVA). There was no significant difference in the 3-year mortality between CVA and ST groups (P = .29). The Cox proportional hazards model showed that ST (adjusted hazard ratio 4.97, 95% CI 2.58-9.56, P < .001) and CVA (adjusted hazard ratio 2.25 [1.25-4.04], P = .006) were independently associated with the increased risk of 3-year mortality.<br />Conclusion: Inhospital ST and CVA after PCI are associated with the increased risk of 3-year mortality. Both events seem to have a similar impact on long-term survival.<br /> (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Coronary Angiography methods
Female
Germany epidemiology
Hospitalization statistics & numerical data
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Percutaneous Coronary Intervention methods
Percutaneous Coronary Intervention statistics & numerical data
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Coronary Artery Disease diagnosis
Coronary Artery Disease mortality
Coronary Artery Disease surgery
Drug-Eluting Stents adverse effects
Graft Occlusion, Vascular diagnosis
Graft Occlusion, Vascular epidemiology
Graft Occlusion, Vascular mortality
Percutaneous Coronary Intervention adverse effects
Stroke epidemiology
Stroke etiology
Thrombosis diagnosis
Thrombosis epidemiology
Thrombosis etiology
Thrombosis mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6744
- Volume :
- 168
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- American heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 25458649
- Full Text :
- https://doi.org/10.1016/j.ahj.2014.08.015