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Stroke after PCI needs further research
Periprocedural stroke in patients undergoing PCI occurs rarely in daily clinical practice in Europe. However, treatment of patients with periprocedural stroke needs further research due to a high mortality rate in these patients, concluded a study published in Circulation: Cardiovascular Interventions.
Researchers of the study examined data on 46,888 patients enrolled in the PCI Registry of the Euro Heart Survey Programme. All patients underwent PCI between May 2005 and April 2008 at 176 different centers in Europe.
Overall, stroke occurred 0.4% of the time following PCI — 0.3% of the time in elective patients and 0.6% of the time in patients who had PCI for ACS. For patients who had stroke as a complication of PCI, mortality was 19.2% (elective PCI, 10%; PCI for ACS, 23.2%) compared with 1.3% in patients who did not have a stroke following PCI.
Independent predictors for periprocedural stroke in ACS, according to multivariate analysis, included hemodynamic instability, age of 75 years or older, history of stroke and congestive HF. However, only PCI of a bypass graft and renal failure predicted stroke in elective patients.
“Peri-interventional stroke is still associated with an exceedingly high in-hospital mortality rate. Most predictors for periprocedural stroke are not modifiable and cannot be diminished before PCI,” the researchers wrote. “Therefore, treatment of patients with stroke after PCI needs further research.”
Disclosure: The researchers report no relevant financial disclosures.