Stroke Complicating Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction
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概要
- 論文の詳細を見る
Background Stroke associated with percutaneous coronary intervention (PCI) is a tragic complication. De-spite advances in the practice of PCI, the incidence of stroke complicating PCI has not changed over the decades. The objective of the present study was to evaluate incidence and correlates of stroke occurring in patients with myocardial infarction (MI) undergoing PCI. Methods and Results Stroke was defined as the presence of any new focal neurological deficit lasting ≥24h that occurred anytime during or after PCI until discharge. In 2,281 consecutive patients with PCIs for non-ST-elevation MI, or ST-elevation MI (STEMI), 20 strokes were identified (0.88%). Strokes were ischemic in 95%. On multivariate analyses, ejection fraction ≤30% (odds ratio=4.3, p=0.003) was the only independent predictor for stroke. In patients who developed stroke within 24 h of PCI, PCI of vein grafts was more frequent, and use of glycoprotein IIb/IIIa inhibitor was less frequent. Those patients tended to present late in the course of MI. Stroke found more than 24 h after PCI was related to diabetes, higher serum creatinine, lower ejection fraction, anterior wall STEMI and emergency use of intra-aortic balloon pumps. Conclusions Low ejection fraction was the only independent predictor for stroke, but risk factors for periprocedural stroke are different from those of stroke occurring more than 24 h after PCI. Upstream use of glycoprotein IIb/IIla inhibitor might decrease the risk of periprocedural stroke.
- 社団法人日本循環器学会の論文
- 2007-08-20
著者
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Lombardi Daniel
Departments Of Cardiovascular Medicine
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Kawamura Akio
Department of Cardiopulmonary, School of Medicine, Keio University
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Kawamura Akio
Departments Of Cardiovascular Medicine
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Tilem Matthew
Neurology, Lahey Clinic Medical Center
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Gossman David
Departments of Cardiovascular Medicine
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Piemonte Thomas
Departments of Cardiovascular Medicine
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Nesto Richard
Departments of Cardiovascular Medicine
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Tilem Matthew
Neurology Lahey Clinic Medical Center
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Gossman David
Department Of Cardiovascular Medicine Lahey Clinic Medical Center
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Piemonte Thomas
Department Of Cardiovascular Medicine Lahey Clinic Medical Center
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Nesto Richard
Department Of Cardiovascular Medicine Lahey Clinic Medical Center
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