Impact of inhospital stent thrombosis and cerebrovascular accidents on long-term prognosis after percutaneous coronary intervention.

Abstract

BACKGROUND:

Inhospital stent thrombosis (ST) and cerebrovascular accidents (CVA) are rare but serious adverse events after percutaneous coronary intervention (PCI). The association of ST or CVA with long-term outcome after PCI remains poorly investigated.

METHODS:

The study included 18,334 consecutive patients who underwent PCI. Patients were divided into 3 groups: the group with ST, the group with CVA, and the group without these events. The primary outcome was all-cause mortality at 3-year follow-up.

RESULTS:

Inhospital ST or CVA occurred in 59 patients (0.32%) and in 90 patients (0. 49%), respectively. There were 2,149 deaths (11.7%) during the follow-up: 26 deaths among patients with ST, 32 deaths among patients with CVA, and 2,091 deaths among patients without ST or CVA (Kaplan-Meier estimates of 3-year mortality 45.3%, 38.0%, and 12.9%, odds ratio 6.1, 95% CI 3.6-10.2, P < .001 for ST group vs the group without ST or CVA and odds ratio 4.2 [2.7-6.6], P < .001 for CVA group vs the group without ST or CVA). There was no significant difference in the 3-year mortality between CVA and ST groups (P = .29). The Cox proportional hazards model showed that ST (adjusted hazard ratio 4.97, 95% CI 2.58-9.56, P < .001) and CVA (adjusted hazard ratio 2.25 [1.25-4.04], P = .006) were independently associated with the increased risk of 3-year mortality.

CONCLUSION:

Inhospital ST and CVA after PCI are associated with the increased risk of 3-year mortality. Both events seem to have a similar impact on long-term survival.

• Authors: Elena Guerra, Gjin Ndrepepa, Stefanie Schulz, Robert Byrne, Petra Hoppmann, Sebastian Kufner, Tareq Ibrahim, Tomohisa Tada, Heribert Schunkert, Karl-Ludwig Laugwitz, Adnan Kastrati
• Journal: American heart journal (Am Heart J) Vol. 168 Issue 6 Pg. 862-8.e1 (Dec 2014) ISSN: 1097-6744 [Electronic] United States
• PMID: 25458649 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Topics

• Aged
• Coronary Angiography (methods)
• Coronary Artery Disease (diagnosis, mortality, surgery)
• Drug-Eluting Stents (adverse effects)
• Female
• Germany (epidemiology)
• Graft Occlusion, Vascular (diagnosis, epidemiology, mortality)
• Hospitalization (statistics & numerical data)
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Percutaneous Coronary Intervention (adverse effects, methods, statistics & numerical data)
• Prognosis
• Proportional Hazards Models
• Retrospective Studies
• Risk Factors
• Stroke (epidemiology, etiology)
• Thrombosis (diagnosis, epidemiology, etiology, mortality)
• Time Factors
• Treatment Outcome