Stroke complicating percutaneous coronary interventions: incidence, predictors, and prognostic implications.

Area of Science:

• Cardiology
• Neurology
• Interventional Cardiology

Background:

• Stroke is a rare but serious complication of percutaneous coronary intervention (PCI).
• Understanding the incidence, predictors, and outcomes of periprocedural stroke is crucial for patient management.

Purpose of the Study:

• To investigate the incidence, predictors, and prognostic impact of periprocedural stroke in patients undergoing PCI.

Main Methods:

• Retrospective study of 9662 patients undergoing 12,407 PCIs between January 1990 and July 1999.
• Analysis of stroke diagnosis, patient characteristics, procedural complications, and mortality rates.
• Multivariate logistic regression to identify stroke predictors.

Main Results:

• Stroke occurred in 0.38% of procedures (43 patients).
• Stroke patients were older, had lower ejection fraction, and higher rates of diabetes and intraprocedural complications requiring intra-aortic balloon pump (IABP) use.
• In-hospital and 1-year mortality were significantly higher in patients with stroke (37.2% and 56.1%, respectively).
• Emergency IABP use was the strongest predictor of stroke (OR=9.6), followed by prophylactic IABP, age >80, and vein graft intervention.

Conclusions:

• Stroke associated with PCI significantly increases mortality.
• Elderly patients experiencing intraprocedural complications requiring IABP are at high risk for stroke.