Differences in baseline characteristics and in-hospital outcomes in patients with or without prior stroke undergoing percutaneous coronary intervention.
BACKGROUND
Percutaneous coronary intervention (PCI) is increasingly used in patients with high-risk baseline characteristics. A prior stroke may identify patients who have a higher risk for post-PCI complications. However, no comparative data exist on post-PCI outcomes of patients with or without prior stroke.


METHODS
Review of a PCI database of 9,088 consecutive PCIs from July 1997 to December 2002 identified 812 PCIs in patients with a history of prior stroke and 8,044 PCIs without prior stroke.


RESULTS
Patients with prior stroke had high-risk baseline characteristics [diabetes, hypertension, hyperlipidemia, smoking, peripheral arterial disease, congestive heart failure, chronic renal failure, history of prior myocardial infarction and prior coronary artery bypass graft (CABG)] and high-risk coronary anatomy (p < 0.001 for each one). The triple composite (death, myocardial infarction and emergent CABG) and the triple composite plus post-PCI stroke were higher in patients with prior stroke (11.2% vs. 4.8%; p < 0.001; z = 7.617 and 12.1% vs. 5.0%; p < 0.001; z = 8.271, respectively.


CONCLUSIONS
Patients with prior stroke constitute a high-risk PCI cohort with higher rates of in-hospital adverse events. A prior stroke history should be considered in evaluating potential candidates for PCI.
Upadhya
Bharathi
B
Cardiology Section, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1045, USA.
Sane
David C
DC
Applegate
Robert J
RJ
Kutcher
Michael A
MA
Gandhi
Sanjay K
SK
Deliargyris
Efthymios N
EN
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods / Q000401:mortality*; D016022:Case-Control Studies; D016001:Confidence Intervals; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000175:diagnosis*; D016896:Treatment Outcome