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Incidence and Risk Factors of Cerebrovascular Events Following Cardiac Catheterization
BACKGROUND: One of the most daunting complications of cardiac catheterization is a cerebrovascular event (CVE). We aimed to assess the real‐life incidence, etiology, and risk factors of cardiac catheterization‐related acute CVEs in a large cohort of patients treated in a single center. METHODS AND R...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Blackwell Publishing Ltd
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886771/ https://www.ncbi.nlm.nih.gov/pubmed/24231658 http://dx.doi.org/10.1161/JAHA.113.000413 |
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author | Korn‐Lubetzki, Isabelle Farkash, Rivka Pachino, Rachel M. Almagor, Yaron Tzivoni, Dan Meerkin, David |
author_facet | Korn‐Lubetzki, Isabelle Farkash, Rivka Pachino, Rachel M. Almagor, Yaron Tzivoni, Dan Meerkin, David |
author_sort | Korn‐Lubetzki, Isabelle |
collection | PubMed |
description | BACKGROUND: One of the most daunting complications of cardiac catheterization is a cerebrovascular event (CVE). We aimed to assess the real‐life incidence, etiology, and risk factors of cardiac catheterization‐related acute CVEs in a large cohort of patients treated in a single center. METHODS AND RESULTS: We undertook a retrospective analysis of 43 350 coronary procedures performed on 30 907 procedure days over the period 1992‐2011 and compared patient and procedural characteristics of procedures complicated by CVEs with the remaining cohort. CVEs occurred in 47 cases: 43 were ischemic, 3 intracerebral hemorrhages, and 1 undetermined. The overall CVE rate was 0.15%, with percutaneous coronary intervention (PCI) and diagnostic coronary angiography rates 0.23% and 0.09%, respectively. Using a forward stepwise multivariate logistic regression model including patient demographic and procedural characteristics, a total of 5 significant predictors were defined: prior stroke (OR=15.09, 95% CI [8.11 to 28.08], P<0.0001), presence of coronary arterial thrombus (OR=2.79, 95% CI [1.25 to 6.22], P=0.012), age >75 years (OR=3.33, 95% CI [1.79 to 6.19], P<0.0001), triple vessel disease (OR=2.24, 95% CI [1.20 to 4.18], P=0.011), and performance of intervention (OR=2.21, 95% CI [1.12 to 4.33], P=0.021). An additional analysis excluded any temporal change of CVE rates but demonstrated a significant increase of all high‐risk patient features. CONCLUSION: In a single‐center, retrospective assessment over nearly 20 years, cardiac catheterization‐related CVEs were very rare and nearly exclusively ischemic. The independent predictors for these events were found to be the performance of an intervention and those associated with increased atherosclerotic burden, specifically older age, triple vessel disease, and prior stroke. The presence of intracoronary thrombus appears also to raise the risk of procedure‐related CVE. |
format | Online Article Text |
id | pubmed-3886771 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Blackwell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-38867712014-01-10 Incidence and Risk Factors of Cerebrovascular Events Following Cardiac Catheterization Korn‐Lubetzki, Isabelle Farkash, Rivka Pachino, Rachel M. Almagor, Yaron Tzivoni, Dan Meerkin, David J Am Heart Assoc Original Research BACKGROUND: One of the most daunting complications of cardiac catheterization is a cerebrovascular event (CVE). We aimed to assess the real‐life incidence, etiology, and risk factors of cardiac catheterization‐related acute CVEs in a large cohort of patients treated in a single center. METHODS AND RESULTS: We undertook a retrospective analysis of 43 350 coronary procedures performed on 30 907 procedure days over the period 1992‐2011 and compared patient and procedural characteristics of procedures complicated by CVEs with the remaining cohort. CVEs occurred in 47 cases: 43 were ischemic, 3 intracerebral hemorrhages, and 1 undetermined. The overall CVE rate was 0.15%, with percutaneous coronary intervention (PCI) and diagnostic coronary angiography rates 0.23% and 0.09%, respectively. Using a forward stepwise multivariate logistic regression model including patient demographic and procedural characteristics, a total of 5 significant predictors were defined: prior stroke (OR=15.09, 95% CI [8.11 to 28.08], P<0.0001), presence of coronary arterial thrombus (OR=2.79, 95% CI [1.25 to 6.22], P=0.012), age >75 years (OR=3.33, 95% CI [1.79 to 6.19], P<0.0001), triple vessel disease (OR=2.24, 95% CI [1.20 to 4.18], P=0.011), and performance of intervention (OR=2.21, 95% CI [1.12 to 4.33], P=0.021). An additional analysis excluded any temporal change of CVE rates but demonstrated a significant increase of all high‐risk patient features. CONCLUSION: In a single‐center, retrospective assessment over nearly 20 years, cardiac catheterization‐related CVEs were very rare and nearly exclusively ischemic. The independent predictors for these events were found to be the performance of an intervention and those associated with increased atherosclerotic burden, specifically older age, triple vessel disease, and prior stroke. The presence of intracoronary thrombus appears also to raise the risk of procedure‐related CVE. Blackwell Publishing Ltd 2013-12-19 /pmc/articles/PMC3886771/ /pubmed/24231658 http://dx.doi.org/10.1161/JAHA.113.000413 Text en © 2013 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Korn‐Lubetzki, Isabelle Farkash, Rivka Pachino, Rachel M. Almagor, Yaron Tzivoni, Dan Meerkin, David Incidence and Risk Factors of Cerebrovascular Events Following Cardiac Catheterization |
title | Incidence and Risk Factors of Cerebrovascular Events Following Cardiac Catheterization |
title_full | Incidence and Risk Factors of Cerebrovascular Events Following Cardiac Catheterization |
title_fullStr | Incidence and Risk Factors of Cerebrovascular Events Following Cardiac Catheterization |
title_full_unstemmed | Incidence and Risk Factors of Cerebrovascular Events Following Cardiac Catheterization |
title_short | Incidence and Risk Factors of Cerebrovascular Events Following Cardiac Catheterization |
title_sort | incidence and risk factors of cerebrovascular events following cardiac catheterization |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886771/ https://www.ncbi.nlm.nih.gov/pubmed/24231658 http://dx.doi.org/10.1161/JAHA.113.000413 |
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