Stroke complicating percutaneous coronary intervention in patients with acute myocardial infarction

Akio Kawamura, Daniel A. Lombardi, Matthew E. Tilem, David E. Gossman, Thomas C. Piemonte, Richard W. Nesto

研究成果: Article

14 引用 (Scopus)

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Background: Stroke associated with percutaneous coronary intervention (PCI) is a tragic complication. Despite advances in the practice of PCI, the incidence of stroke complicating PCI has not changed over the decades. The objective of the present study was to evaluate incidence and correlates of stroke occurring in patients with myocardial infarction (MI) undergoing PCI. Methods and Results: Stroke was defined as the presence of any new focal neurological deficit lasting ≥24h that occurred anytime during or after PCI until discharge. In 2,281 consecutive patients with PCIs for non-ST-elevation MI, or ST-elevation MI (STEMI), 20 strokes were identified (0.88%). Strokes were ischemic in 95%. On multivariate analyses, ejection fraction ≤30% (odds ratio=4.3, p=0.003) was the only independent predictor for stroke. In patients who developed stroke within 24 h of PCI, PCI of vein grafts was more frequent, and use of glycoprotein IIb/IIIa inhibitor was less frequent. Those patients tended to present late in the course of MI. Stroke found more than 24 h after PCI was related to diabetes, higher serum creatinine, lower ejection fraction, anterior wall STEMI and emergency use of intra-aortic balloon pumps. Conclusions: Low ejection fraction was the only independent predictor for stroke, but risk factors for periprocedural stroke are different from those of stroke occurring more than 24 h after PCI. Upstream use of glycoprotein IIb/IIIa inhibitor might decrease the risk of periprocedural stroke.

元の言語English
ページ(範囲)1370-1375
ページ数6
ジャーナルCirculation Journal
71
発行部数9
DOI
出版物ステータスPublished - 2007 9 13

    フィンガープリント

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

これを引用

Kawamura, A., Lombardi, D. A., Tilem, M. E., Gossman, D. E., Piemonte, T. C., & Nesto, R. W. (2007). Stroke complicating percutaneous coronary intervention in patients with acute myocardial infarction. Circulation Journal, 71(9), 1370-1375. https://doi.org/10.1253/circj.71.1370