Safety of percutaneous coronary intervention in patients with acute ischemic stroke/transient ischemic attack and acute coronary syndrome
- 29 October 2015
- journal article
- Published by Springer Science and Business Media LLC in Clinical Research in Cardiology
- Vol. 105 (4), 356-363
- https://doi.org/10.1007/s00392-015-0928-y
Abstract
Cardiac events in patients with acute stroke are frequent. Urgent PCI in myocardial infarction is crucial to improve outcome. However, the situation is complex as intracranial hemorrhage is a frequent complication of stroke but antithrombotic medication is indispensable during and after PCI. Therefore in this study, we aimed to investigate the safety of percutaneous coronary intervention (PCI) in patients hospitalized with acute ischemic stroke and concomitant acute coronary syndrome (ACS). In a single-center, case-series study we investigated 80 patients hospitalized with acute stroke/transient ischemic attack (TIA) and concomitant ACS undergoing coronary angiography. Patients with subsequent PCI were compared to patients with medical treatment alone. The primary end point was the composite of death, recurrent MI, coronary re-intervention, recurrent stroke or bleeding during 1-year follow-up. The secondary end point consisted of the components of the primary end point. Age, gender and cardiovascular risk factors did not differ between groups. However, severity of initial stroke and coronary artery disease was higher in the PCI group. Accordingly, antiplatelet medication with aspirin and clopidogrel was prescribed more frequently in the PCI group. Nevertheless, during 1-year follow-up, the primary end point did not differ between groups [38 vs. 50 %, odds ratio (OR) 1.7, CI 0.69–4.07, P = 0.23]. Intracranial hemorrhage was even numerically lower in patients undergoing PCI (5 vs. 3 %, OR 0.4, CI 0.04–5.6, P = 0.46). The primary and secondary end points were not enhanced in patients undergoing PCI. Therefore PCI is safe in patients with stroke/TIA and concomitant ACS.Keywords
This publication has 45 references indexed in Scilit:
- Rationale and design of the RE-LATED AF—AFNET 7 trial: REsolution of Left atrial-Appendage Thrombus—Effects of Dabigatran in patients with Atrial FibrillationClinical Research in Cardiology, 2015
- The association of the QT interval with atrial fibrillation and stroke: the Multi-Ethnic Study of AtherosclerosisClinical Research in Cardiology, 2015
- Early results of first versus second generation Amplatzer occluders for left atrial appendage closure in patients with atrial fibrillationClinical Research in Cardiology, 2015
- Prevalence and impact on outcome of electrocardiographic early repolarization patterns among stroke patients: a prospective observational studyClinical Research in Cardiology, 2015
- Risk of Stent Thrombosis Among Bare-Metal Stents, First-Generation Drug-Eluting Stents, and Second-Generation Drug-Eluting StentsКАРДИОЛОГИЯ УЗБЕКИСТАНА, 2013
- Repeat Revascularization After Contemporary Percutaneous Coronary InterventionCirculation: Cardiovascular Interventions, 2012
- The patient’s interpretation of myocardial infarction symptoms and its role in the decision process to seek treatment: the MONICA/KORA Myocardial Infarction RegistryClinical Research in Cardiology, 2012
- Long-term clinical outcomes following sirolimus-eluting stent implantation in patients with acute myocardial infarction. A meta-analysis of randomized trialsClinical Research in Cardiology, 2012
- Everolimus-eluting stents for treatment of chronic total coronary occlusionsClinical Research in Cardiology, 2011
- Standardized Bleeding Definitions for Cardiovascular Clinical TrialsCirculation, 2011