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Prognostic significance of prior ischemic stroke in patients with coronary artery disease undergoing percutaneous coronary intervention.
- Source :
-
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2019 Feb 15; Vol. 93 (S1), pp. 787-792. Date of Electronic Publication: 2019 Jan 07. - Publication Year :
- 2019
-
Abstract
- Objectives: To investigate the long-term outcomes of percutaneous coronary intervention (PCI) in patients with previous ischemic stroke.<br />Background: Ischemic stroke and coronary artery disease (CAD) are leading causes of death that often coexist with each other. With the increased use of PCI in high-risk patients with CAD, the association between prior ischemic stroke and cardiovascular/cerebrovascular events in patients with CAD undergoing PCI has been a topic of interest.<br />Methods: We enrolled 10,300 consecutive patients who had undergone PCI from January 2013 to December 2013 and classified them into the prior ischemic stroke group (n = 1,106) and no prior ischemic stroke group (n = 9,194). The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCEs) during follow-up. The secondary endpoints included each component of the primary endpoint and stent thrombosis (ST).<br />Results: Overall, 10.7% patients had a history of ischemic stroke. At a median 29-month follow-up, MACCEs following PCI occurred with 2-year incidences of 15.4% in the prior ischemic stroke group and 11.7% in the no prior ischemic stroke group. Cox regression analysis demonstrated that prior ischemic stroke was independently associated with a higher risk of MACCEs (adjusted hazard ratio [HR] = 1.294; 95% confidence interval [CI]: 1.100-1.522; P = 0.002), recurrent stroke (adjusted HR = 2.463; 95% CI: 1.729-3.507; P = 0.000), and ST (adjusted HR = 1.787; 95% CI: 1.075-2.971; P = 0.025). A high residual syntax score and low renal function were independent risk factors for MACCEs.<br />Conclusions: Increased concern and active treatment strategies are needed in patients undergoing PCI who have a history of ischemic stroke.<br /> (© 2019 Wiley Periodicals, Inc.)
- Subjects :
- Aged
Beijing epidemiology
Brain Ischemia diagnostic imaging
Brain Ischemia mortality
Coronary Artery Disease diagnostic imaging
Coronary Artery Disease mortality
Coronary Thrombosis epidemiology
Female
Humans
Incidence
Male
Middle Aged
Myocardial Infarction epidemiology
Progression-Free Survival
Retrospective Studies
Risk Assessment
Risk Factors
Stents
Stroke diagnostic imaging
Stroke mortality
Time Factors
Brain Ischemia epidemiology
Coronary Artery Disease therapy
Percutaneous Coronary Intervention adverse effects
Percutaneous Coronary Intervention instrumentation
Percutaneous Coronary Intervention mortality
Stroke epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1522-726X
- Volume :
- 93
- Issue :
- S1
- Database :
- MEDLINE
- Journal :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
- Publication Type :
- Academic Journal
- Accession number :
- 30618111
- Full Text :
- https://doi.org/10.1002/ccd.28057