title: Safety of percutaneous coronary intervention in patients with acute ischemic stroke/transient ischemic attack and acute coronary syndrome.
abstract: BACKGROUND
  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).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Dusseldorf, Düsseldorf, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Zeus
authors.affiliation: Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Dusseldorf, Düsseldorf, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ketterer
authors.affiliation: Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Dusseldorf, Düsseldorf, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Leuf
authors.affiliation: Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Dusseldorf, Düsseldorf, Germany.
authors.forename: Lisa
authors.initials: L
authors.lastname: Dannenberg
authors.affiliation: Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Dusseldorf, Düsseldorf, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Bönner
authors.affiliation: Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Dusseldorf, Düsseldorf, Germany.
authors.forename: Rabea
authors.initials: R
authors.lastname: Wagstaff
authors.affiliation: Department of Neurology, Heinrich Heine University, Düsseldorf, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Gliem
authors.affiliation: Department of Neurology, Heinrich Heine University, Düsseldorf, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Jander
authors.affiliation: Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Dusseldorf, Düsseldorf, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
authors.affiliation: Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Dusseldorf, Düsseldorf, Germany. amin.polzin@med.uni-duesseldorf.de.
authors.forename: Amin
authors.initials: A
authors.lastname: Polzin
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D005260:Female; D005858:Germany; D006760:Hospitalization; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D010865:Pilot Projects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Acute coronary syndrome; Myocardial infarction; PCI; Safety; Stroke