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Frequency and predictors of diagnostic coronary angiography and percutaneous coronary intervention related to stroke

Bartłomiej Staszczak, Krzysztof P Malinowski, Wojciech Wańha, Zbigniew Siudak, Magdalena Jędrychowska, Michał Susuł, Sławomir Surowiec, Szymon Darocha, Andrzej Surdacki, Marcin Kurzyna, Wojciech Wojakowski, Jacek Legutko, Krzysztof Bartuś, Stanisław Bartuś, Rafał Januszek
DOI: 10.33963/KP.a2021.0100
·
Pubmed: 34472076

open access

Online first
Original article
Published online: 2021-08-31

Abstract

Background: Stroke related to percutaneous coronary interventions (PCIs) is an infrequent complication, potentially life-threatening and often leading to serious disability.

Aims: The study aim is to assess the relationship between the type of coronary procedure and incidence of stroke as well as its predictors.

Methods: This retrospective analysis was performed on prospectively collected data gathered in the Polish National Registry of Percutaneous Coronary Interventions (ORPKI) between January 2014 and December 2019, and included 1 177 161 coronary procedures. Among them, 650,674 patients underwent isolated diagnostic coronary angiography (DCA) and 526,487 PCI. Stroke was diagnosed in 157 patients (0.013%), of which 100 (0.015%) during DCA and 57 (0.011%) during PCI. Multivariable logistic regression analysis was performed to separate predictors of stroke in patients undergoing coronary angiography and PCI.

Results: The percentage of patients with periprocedural stroke was higher in a group treated with isolated DCA during the analysed time. Among predictors of stroke in patients undergoing DCA we confirmed prior stroke (P <0.001), contrast amount (P = 0.007), femoral access (P = 0.002), unfractionated heparin use (P = 0.01), direct transport (P = 0.04), older age (P <0.001) and multi-vessel disease (P <0.001). While for PCI ± DCA, these were: prior stroke (P <0.001), thrombolysis (P = 0.003), treatment with bivalirudin (P <0.001) and acetyl-salicylic acid loading during PCI (P = 0.003).

Conclusions: Based on the large national registry, PCI ± DCA is associated with fewer risk factors and lower rate of periprocedural strokes than isolated DCA.

Abstract

Background: Stroke related to percutaneous coronary interventions (PCIs) is an infrequent complication, potentially life-threatening and often leading to serious disability.

Aims: The study aim is to assess the relationship between the type of coronary procedure and incidence of stroke as well as its predictors.

Methods: This retrospective analysis was performed on prospectively collected data gathered in the Polish National Registry of Percutaneous Coronary Interventions (ORPKI) between January 2014 and December 2019, and included 1 177 161 coronary procedures. Among them, 650,674 patients underwent isolated diagnostic coronary angiography (DCA) and 526,487 PCI. Stroke was diagnosed in 157 patients (0.013%), of which 100 (0.015%) during DCA and 57 (0.011%) during PCI. Multivariable logistic regression analysis was performed to separate predictors of stroke in patients undergoing coronary angiography and PCI.

Results: The percentage of patients with periprocedural stroke was higher in a group treated with isolated DCA during the analysed time. Among predictors of stroke in patients undergoing DCA we confirmed prior stroke (P <0.001), contrast amount (P = 0.007), femoral access (P = 0.002), unfractionated heparin use (P = 0.01), direct transport (P = 0.04), older age (P <0.001) and multi-vessel disease (P <0.001). While for PCI ± DCA, these were: prior stroke (P <0.001), thrombolysis (P = 0.003), treatment with bivalirudin (P <0.001) and acetyl-salicylic acid loading during PCI (P = 0.003).

Conclusions: Based on the large national registry, PCI ± DCA is associated with fewer risk factors and lower rate of periprocedural strokes than isolated DCA.

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Keywords

coronary angiography; percutaneous coronary intervention; periprocedural complication; stroke

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Title

Frequency and predictors of diagnostic coronary angiography and percutaneous coronary intervention related to stroke

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-08-31

DOI

10.33963/KP.a2021.0100

Pubmed

34472076

Keywords

coronary angiography
percutaneous coronary intervention
periprocedural complication
stroke

Authors

Bartłomiej Staszczak
Krzysztof P Malinowski
Wojciech Wańha
Zbigniew Siudak
Magdalena Jędrychowska
Michał Susuł
Sławomir Surowiec
Szymon Darocha
Andrzej Surdacki
Marcin Kurzyna
Wojciech Wojakowski
Jacek Legutko
Krzysztof Bartuś
Stanisław Bartuś
Rafał Januszek

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