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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Prior ischemic stroke is not associated with worse clinical outcomes in patients undergoing percutaneous coronary

Ming Zhang1, Raviteja R Guddeti, Shao-ping Wang

  • 1. zhangming2279@hotmail.com.

Clinical and Investigative Medicine. Medecine Clinique Et Experimentale
|August 5, 2014
PubMed

Insights

Percutaneous coronary intervention (PCI) is safe and effective for patients with prior ischemic stroke. Outcomes were similar to those without a stroke history, indicating good results in clinical practice.

Area of Science:

  • Cardiology
  • Neurology
  • Interventional Cardiology

Background:

  • Cerebrovascular accidents (CVAs) often coexist with coronary artery disease (CAD).
  • Prior ischemic stroke can negatively impact prognosis in patients with CAD.
  • Limited research exists on the outcomes of percutaneous coronary intervention (PCI) in patients with a history of stroke.

Purpose of the Study:

  • To evaluate the safety and effectiveness of PCI in patients with a prior ischemic stroke.
  • To determine if a history of ischemic stroke independently predicts adverse outcomes after PCI.

Main Methods:

  • Retrospective review of 3893 PCI patients (June 2003-September 2005).
  • Comparison of 295 patients with prior ischemic stroke (≥3 months) versus 3598 patients without prior stroke.
  • Univariate and Cox multivariate regression analyses, followed by propensity score matching.

Main Results:

  • Patients with prior stroke had more comorbidities (diabetes, hypertension, hyperlipidemia, prior myocardial infarction).
  • No significant difference in major adverse cardiac and cerebrovascular event (MACCE) rates between groups (1.7% vs. 1.4%, p=0.06).
  • Independent predictors of MACCE in stroke patients included diabetes, triple-vessel CAD, number of diseased vessels, chronic total occlusion, and prior myocardial infarction.

Conclusions:

  • PCI is safe and effective for patients with a prior ischemic stroke (≥3 months) in routine clinical practice.
  • Outcomes are comparable to patients without a history of stroke.
Abstract

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