Invasive cardiac procedures prior to in-hospital acute ischemic stroke were not significantly associated with lower adjusted in-hospital mortality (aOR 0.70; 95% CI 0.41-1.17).
Cohort (n=499)
Sí
Do invasive cardiac procedures impact in-hospital mortality in patients with in-hospital acute ischemic stroke admitted for a cardiac diagnosis?
In patients admitted with cardiac conditions who suffer in-hospital stroke, prior cardiac procedures do not independently alter overall mortality, but delayed strokes (>2 days post-procedure) are associated with significantly higher mortality.
Estimación del efecto: aOR 0.70 (95% CI 0.41-1.17)
Tasa de eventos absoluta: 23% vs 34.6%
valor p: p=0.007
Abstract Background and aims It is unclear if stroke after cardiac procedures is more severe than stroke associated with other cardiac conditions. We compared in-hospital acute ischemic stroke (AIS) patients primarily admitted with a cardiac diagnosis who did versus did not undergo invasive cardiac procedures. Methods In a retrospective cohort study, we analyzed adults with in-hospital AIS primarily admitted with a cardiac diagnosis in Alberta (2018-2022). We compared clinical characteristics and outcomes between patients who did versus did not undergo invasive cardiac procedures 30 days before AIS. We estimated associations between having undergone procedures and outcomes using multivariable logistic regression. Results Among 499 patients admitted for a cardiac diagnosis (median age 70 years IQR 62-77, 36.7% women), 343 (68.7%) underwent any cardiac procedure prior to their in-hospital stroke. Coronary bypass grafting (92/343 26.8%) was the most common procedure. Median time from procedure to stroke diagnosis was 1.75 days (IQR 0.87–3.83). In-hospital mortality was nominally lower in the procedure group (79/343 23.0% vs 54/156 34.6%, p-value 0.007) but not after adjustment for age, sex and facility level (aOR 0.70, 95% CI 0.41-1.17). ICU admission was higher in the procedure group (62.7% vs 31.4%, p0.001), while medical complication rates were similar. In the procedure group, strokes 2 days post-procedure were associated with higher mortality (2-7 days: OR 2.24, 1.17–4.30; 8-30 days: OR 3.23, 1.59–6.58); age, sex, procedure type, and acute treatment were not. Conclusions Delayed procedure-related strokes are associated with higher mortality, emphasizing vigilance in hospitalized cardiac patients. Conflict of interest Ameen Alizada: nothing to disclose. Rana Abdalrahman: nothing to disclose. Dana Harris: nothing to disclose. Jillian Stang: nothing to disclose. Benjamin Agnelli: nothing to disclose. Jessalyn Holodinsky: nothing to disclose. Bijoy Menon: nothing to disclose. Michael Hill: nothing to disclose. Mohammed Almekhlafi: nothing to disclose. Katrina Hannah Ignacio: nothing to disclose.
Alizada et al. (Fri,) conducted a cohort in In-hospital acute ischemic stroke with a primary cardiac diagnosis (n=499). Invasive cardiac procedures vs. No invasive cardiac procedures was evaluated on In-hospital mortality (aOR 0.70, 95% CI 0.41-1.17, p=0.007). Invasive cardiac procedures prior to in-hospital acute ischemic stroke were not significantly associated with lower adjusted in-hospital mortality (aOR 0.70; 95% CI 0.41-1.17).