Related Experiment Videos

Differences in baseline characteristics and in-hospital outcomes in patients with or without prior stroke undergoing

Bharathi Upadhya1, David C Sane, Robert J Applegate

  • 1Cardiology Section, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1045, USA.

The Journal of Invasive Cardiology
|May 10, 2005
PubMed

Insights

Patients with a history of prior stroke undergoing percutaneous coronary intervention (PCI) face higher risks for adverse events. This finding highlights the importance of considering stroke history in PCI candidate evaluation.

Area of Science:

  • Cardiology
  • Neurology
  • Interventional Cardiology

Background:

  • Percutaneous coronary intervention (PCI) is frequently performed in high-risk patients.
  • Prior stroke may indicate increased risk for post-PCI complications.
  • Comparative data on PCI outcomes in patients with and without prior stroke are limited.

Purpose of the Study:

  • To compare in-hospital adverse events after PCI in patients with and without a history of prior stroke.
  • To identify if prior stroke is associated with increased risk in the PCI population.

Main Methods:

  • Retrospective review of a PCI database (July 1997-December 2002).
  • Analysis included 812 patients with prior stroke and 8,044 patients without prior stroke.
  • Outcomes assessed included a composite of death, myocardial infarction, emergent coronary artery bypass graft (CABG), and post-PCI stroke.

Main Results:

  • Patients with prior stroke exhibited significantly more high-risk baseline characteristics and coronary anatomy (p < 0.001).
  • The composite endpoint of death, myocardial infarction, and emergent CABG was higher in the prior stroke group (11.2% vs. 4.8%, p < 0.001).
  • The composite endpoint including post-PCI stroke was also significantly higher in patients with prior stroke (12.1% vs. 5.0%, p < 0.001).

Conclusions:

  • Patients with a history of prior stroke represent a high-risk cohort for PCI.
  • Higher rates of in-hospital adverse events are observed in this group.
  • Prior stroke history is a crucial factor to consider when evaluating patients for PCI.
Abstract

Related Concept Videos

Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...