Author + information
- Devraj Sukul,
- Milan Seth,
- David Wohns,
- Simon Dixon,
- Nicklaus Slocum and
- Hitinder Gurm
Background: Due to shared risk factors between coronary artery disease and cerebrovascular disease, patients (pts) with a history of transient ischemic attack (TIA) or cerebrovascular accident (CVA) often undergo percutaneous coronary intervention (PCI). We examined the association between a history of TIA/CVA and outcomes after PCI.
Methods: Of 98,730 pts who underwent PCI from 1/1/13 – 3/31/16 at 47 Michigan hospitals, 10,915 (11%) had a history of TIA/CVA. TIA was defined as loss of neurological function that was abrupt in onset but with complete return of function within 24 hours, whereas CVA required residual symptoms to be present at least 72 hours after onset. In-hospital outcomes included post-procedural stroke, transfusion, bleeding, major bleeding and death. Propensity-matched multivariable analysis was used to adjust for differences in baseline characteristics.
Results: Pts with a history of TIA/CVA were more likely to be older, female, have worse renal function and more cardiovascular comorbidities. After matching (n=10,618 per group), a history of TIA/CVA was associated with a significantly increased risk of post-procedural stroke (0.8% vs 0.4%; P<0.001) (Figure). There were no significant differences in transfusion (4.2% vs 4.4%; P=0.53), bleeding (4.3% vs. 4.0%; P=0.32), major bleeding (1.0% vs 1.1%; P=0.25), or death (2.4% vs. 2.1%; P=0.52).
Conclusions: A history of TIA/CVA was associated with a two-fold increased risk of stroke after PCI without any difference in bleeding or death.
Moderated Poster Contributions
Interventional Cardiology Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 4:00 p.m.-4:10 p.m.
Session Title: Percutaneous Coronary Intervention: Lessons From the Real World
Abstract Category: 19. Interventional Cardiology: Complex Patients/Comorbidities
Presentation Number: 1263M-05
- 2017 American College of Cardiology Foundation