Abstract 17602: Temporal Trends and Outcomes of Percutaneous Coronary Intervention-Related Stroke From 2002 to 2012
Background: Stroke is a rare complication from percutaneous coronary intervention (PCI) and is usually associated with devastating consequences. There has been a lot of progress in PCI with better coronary stents, device technology and pharmacotherapy. This study was conducted to review the contemporary trend in PCI-related stroke in view of the evolution in PCI and changes in patient risk factors.
Method: A total of 23,117 patients who underwent PCI from 2002 to 2012 were retrospectively studied.
Results: Within this population, stroke occurred in 64 patients. The rate of stroke remained unchanged over the past 10 years (p=0.09), with an incidence of 0.29 ± 0.16% per year. There was significant change in baseline risk factors over the years, with a trend for increasing age, smoking, more African Americans, insulin-dependent diabetes mellitus (IDDM), and history of chronic kidney disease (all p <0.001). The percentages of patients per year increased with respect to admissions for myocardial infarction for complex lesion anatomy (type C). Table. However, dyslipidaemia and hypertension displayed a decreasing trend over this time period (p <0.001, respectively). For patients with peri-procedural stroke, the in-hospital length of stay was longer (12 ± 11.3 vs 3.1 ± 4 days, p <0.001) and with higher in-hospital mortality (29.2% vs 1.4%, p <0.001), compared to those without stroke.
Conclusion: Peri-procedural stroke was associated with worse in-hospital outcomes. However, the rate of PCI-related stroke has remained stable over the last 10 years, despite significant changes in risk factors and increasingly complex lesions in patients treated with PCI.
- © 2013 by American Heart Association, Inc.