Key result
Compared to an age-standardized population cohort, stroke rates in the 12 months following percutaneous coronary intervention were higher for patients <65 years old, but lower for those ≥65 years old.
Why the study?
Stroke rates and risk factors may change as PCI practice evolves, and data comparing stroke incidence after PCI to the general population were lacking.
What is the incidence and what are the risk factors for stroke following percutaneous coronary intervention compared to the general population?
Cohort (n=22,618)
Yes
What is the incidence and what are the risk factors for stroke following percutaneous coronary intervention compared to the general population?
Following PCI, inpatient stroke is associated with acute clinical status (e.g., STEMI, renal impairment), whereas outpatient stroke is associated with chronic disease and age, with younger PCI patients facing higher stroke rates than the general population.
Answers are grounded in this paper and cite their sources.
May warrant age-specific post-PCI stroke vigilance in younger patients; leaves open causal mechanisms and practice implications.
BACKGROUND: Stroke rates and risk factors may change as percutaneous coronary intervention practice evolves and no data are available comparing stroke incidence after percutaneous coronary intervention to the general population. AIMS: This study aimed to identify the incidence and risk factors for inpatient and subsequent stroke following percutaneous coronary intervention with comparison to age-matched controls. METHODS: Data were prospectively collected from 22,618 patients undergoing percutaneous coronary intervention in the Melbourne Interventional Group registry (2005-2015). The cohort was compared to the North-East Melbourne Stroke Incidence Study population-based cohort (1997-1999) and predefined variables assessed for association with inpatient or outpatient stroke. Factors independently associated with inpatient stroke were renal impairment, ST-elevation myocardial infarction, previous stroke, left ventricular ejection fraction 30-45%, and female sex, while those associated with outpatient stroke were previous stroke, chronic lung disease, previous myocardial infarction, rheumatoid arthritis, female sex, and older age. Compared to the age-standardized population-based cohort, stroke rates in the 12 months following discharge were higher for percutaneous coronary intervention patients <65 years old, but lower for percutaneous coronary intervention patients ≥65 years old. CONCLUSIONS: Risk of inpatient stroke following percutaneous coronary intervention appears to be largely associated with clinical status at presentation, while outpatient stroke relates more to age and chronic disease. Compared to the general population, outpatient stroke rates following percutaneous coronary intervention are higher for younger, but not older, patients.
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Dawson et al. (2020) conducted a cohort in Patients undergoing percutaneous coronary intervention (n=22,618). Percutaneous coronary intervention vs. Age-standardized population-based cohort was evaluated on Inpatient and outpatient stroke (p=< 0.0001). Compared to an age-standardized population cohort, stroke rates in the 12 months following percutaneous coronary intervention were higher for patients <65 years old, but lower for those ≥65 years old.
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