title: Impact of inhospital stent thrombosis and cerebrovascular accidents on long-term prognosis after percutaneous coronary intervention.
abstract: BACKGROUND
  Inhospital stent thrombosis (ST) and cerebrovascular accidents (CVA) are rare but serious adverse events after percutaneous coronary intervention (PCI). The association of ST or CVA with long-term outcome after PCI remains poorly investigated.
  
  
  METHODS
  The study included 18,334 consecutive patients who underwent PCI. Patients were divided into 3 groups: the group with ST, the group with CVA, and the group without these events. The primary outcome was all-cause mortality at 3-year follow-up.
  
  
  RESULTS
  Inhospital ST or CVA occurred in 59 patients (0.32%) and in 90 patients (0. 49%), respectively. There were 2,149 deaths (11.7%) during the follow-up: 26 deaths among patients with ST, 32 deaths among patients with CVA, and 2,091 deaths among patients without ST or CVA (Kaplan-Meier estimates of 3-year mortality 45.3%, 38.0%, and 12.9%, odds ratio 6.1, 95% CI 3.6-10.2, P < .001 for ST group vs the group without ST or CVA and odds ratio 4.2 [2.7-6.6], P < .001 for CVA group vs the group without ST or CVA). There was no significant difference in the 3-year mortality between CVA and ST groups (P = .29). The Cox proportional hazards model showed that ST (adjusted hazard ratio 4.97, 95% CI 2.58-9.56, P < .001) and CVA (adjusted hazard ratio 2.25 [1.25-4.04], P = .006) were independently associated with the increased risk of 3-year mortality.
  
  
  CONCLUSIONS
  Inhospital ST and CVA after PCI are associated with the increased risk of 3-year mortality. Both events seem to have a similar impact on long-term survival.
authors.affiliation: Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Elena
authors.initials: E
authors.lastname: Guerra
authors.affiliation: Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Gjin
authors.initials: G
authors.lastname: Ndrepepa
authors.affiliation: Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schulz
authors.affiliation: Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Byrne
authors.affiliation: 1.Medizinische Klinik rechts der Isar, Technische Universität, Munich, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Hoppmann
authors.affiliation: Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kufner
authors.affiliation: 1.Medizinische Klinik rechts der Isar, Technische Universität, Munich, Germany.
authors.forename: Tareq
authors.initials: T
authors.lastname: Ibrahim
authors.affiliation: Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Tada
authors.affiliation: Deutsches Herzzentrum München, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
authors.affiliation: 1.Medizinische Klinik rechts der Isar, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.affiliation: Deutsches Herzzentrum München, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. Electronic address: kastrati@dhm.mhn.de.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D013927:Thrombosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome