Stroke following percutaneous coronary intervention in Australia: incidence, trends and risk factors.

Abstract

Background: The incidence of stroke in an Australian percutaneous coronary intervention (PCI) cohort has not been published, and there is conflicting evidence as to whether radial access reduces the risk of this devastating complication.

Methods: This study analysed data from 30,622 patients who underwent PCI between 2005 and 2017, and determined the incidence of in-hospital, and postPCI ischaemic and haemorrhagic stroke. Clinical and procedural data, 30-day and 12-month outcomes were compared between patients with in-hospital postPCI ischaemic stroke, haemorrhagic stroke, and those without stroke (Table).

Results: The incidence of stroke was 0.3% (0.22% ischaemic and 0.08% haemorrhagic). There was no significant difference in the yearly incidence of stroke over the last 13 years. Stage-3 chronic kidney disease (CKD), ST-elevation myocardial ischaemia, and cardiogenic shock were found to be independent predictors of ischaemic stroke. Independent predictors of haemorrhagic stroke included stage-4 CKD and thrombolysis. Access site was not a predictor of ischaemic or haemorrhagic stroke.

Conclusions: The rates of in-hospital stroke following PCI in this Australian cohort were very low and had not significantly changed over the last 13 years. Patients with postPCI stroke had significantly increased short-term and long-term mortality, particularly those with haemorrhagic stroke.