Original Research

DOI: 10.4244/EIJ-D-24-00189

Temporal trends and outcomes of acute ischaemic strokes in patients hospitalised for percutaneous coronary intervention

Benjamin Bay1,2,3, MD; Alina Goßling1,3, MSc; Marko Remmel1, MD, MBA; Peter M. Becher1,2,3, MD; Benedikt Schrage1,2,3, MD, PhD; David L. Rimmele4, MD; Götz Thomalla4, MD; Stefan Blankenberg1,2,3, MD; Peter Clemmensen1,2,3, MD, DMSc; Fabian J. Brunner1,2,3, MD; Christoph Waldeyer1,2, MD

Abstract

BACKGROUND: Acute ischaemic stroke (AIS) after percutaneous coronary intervention (PCI) is a rare, but debilitating, complication. However, contemporary data from real-world unselected patients are scarce.

AIMS: We aimed to explore the temporal trends, outcomes and variables associated with AIS as well as in-hospital all-cause mortality in a nationwide cohort.

METHODS: A retrospective analysis of healthcare records from 2006-2021 was implemented. Patients were stratified according to the occurrence of AIS in the setting of PCI. The temporal trends of AIS were analysed. A stepwise regression model was used to identify variables associated with AIS and in-hospital all-cause mortality.

RESULTS: A total of 4,910,430 PCIs were included for the current analysis. AIS occurred in 4,098 cases (0.08%). An incremental increase in the incidence of AIS after PCI from 0.03% to 0.14% per year was observed from 2006-2021. The strongest associations with AIS after PCI included carotid artery disease, medical history of stroke, atrial fibrillation, presentation with an ST-segment elevation myocardial infarction (STEMI) or non-STEMI and coronary thrombectomy. For patients with AIS, a higher in-hospital all-cause mortality (18.11% vs 3.29%; p<0.001) was documented. With regard to all-cause mortality, the strongest correlations in the stroke cohort were found for cardiogenic shock, dialysis and clinical presentation with a STEMI.

CONCLUSIONS: In an unselected nationwide cohort of patients hospitalised for PCI, a gradual increase in AIS incidence was noted. We identified several variables associated with AIS as well as with in-hospital mortality. Hereby, clinicians might identify the patient population at risk for a peri-interventional AIS as well as those at risk for an adverse in-hospital outcome after PCI.

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Volume 20 Number 17
Sep 2, 2024
Volume 20 Number 17
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