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Acute Ischemic Stroke and Transient Ischemic Attack in ST-Segment Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention

Background: Acute ischemic stroke (AIS) is a rare but critical complication following ST-elevation myocardial infarction (STEMI). The risk of AIS or transient ischemic attack (TIA) may be amplified by invasive procedures, including primary percutaneous coronary intervention (PCI). This study aimed t...

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Autores principales: Murakami, Tsukasa, Sakakura, Kenichi, Jinnouchi, Hiroyuki, Taniguchi, Yousuke, Tsukui, Takunori, Watanabe, Yusuke, Yamamoto, Kei, Seguchi, Masaru, Wada, Hiroshi, Fujita, Hideo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917385/
https://www.ncbi.nlm.nih.gov/pubmed/36769488
http://dx.doi.org/10.3390/jcm12030840
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author Murakami, Tsukasa
Sakakura, Kenichi
Jinnouchi, Hiroyuki
Taniguchi, Yousuke
Tsukui, Takunori
Watanabe, Yusuke
Yamamoto, Kei
Seguchi, Masaru
Wada, Hiroshi
Fujita, Hideo
author_facet Murakami, Tsukasa
Sakakura, Kenichi
Jinnouchi, Hiroyuki
Taniguchi, Yousuke
Tsukui, Takunori
Watanabe, Yusuke
Yamamoto, Kei
Seguchi, Masaru
Wada, Hiroshi
Fujita, Hideo
author_sort Murakami, Tsukasa
collection PubMed
description Background: Acute ischemic stroke (AIS) is a rare but critical complication following ST-elevation myocardial infarction (STEMI). The risk of AIS or transient ischemic attack (TIA) may be amplified by invasive procedures, including primary percutaneous coronary intervention (PCI). This study aimed to investigate the factors associated with in-hospital AIS/TIA in patients with STEMI who required primary PCI. Methods: We included 941 STEMI patients who underwent primary PCI and divided them into an AIS/TIA group (n = 39) and a non-AIS/TIA group (n = 902), according to new-onset AIS/TIA. The primary interest was to find the factors associated with AIS/TIA by multivariate logistic regression analysis. We also compared clinical outcomes between the AIS/TIA and non-AIS/TIA groups. Results: The incidence of in-hospital deaths was significantly higher in the AIS/TIA group (46.2%) than in the non-AIS/TIA group (6.3%) (p < 0.001). Multivariate analysis revealed that cardiogenic shock (OR 3.228, 95% CI 1.492–6.986, p = 0.003), new-onset atrial fibrillation (AF) (OR 2.280, 95% CI 1.033–5.031, p = 0.041), trans-femoral approach (OR 2.336, 95% CI 1.093–4.992, p = 0.029), use of ≥4 catheters (OR 3.715, 95% CI 1.831–7.537, p < 0.001), and bleeding academic research consortium (BARC) type 3 or 5 bleeding (OR 2.932, 95% CI 1.256–6.846, p = 0.013) were significantly associated with AIS/TIA. Conclusion: In STEMI patients with primary PCI, new-onset AIS/TIA was significantly associated with cardiogenic shock, new-onset AF, trans-femoral approach, the use of ≥4 catheters, and BARC type 3 or 5 bleeding. We should recognize these modifiable and unmodifiable risk factors for AIS/TIA in the treatment of STEMI.
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spelling pubmed-99173852023-02-11 Acute Ischemic Stroke and Transient Ischemic Attack in ST-Segment Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention Murakami, Tsukasa Sakakura, Kenichi Jinnouchi, Hiroyuki Taniguchi, Yousuke Tsukui, Takunori Watanabe, Yusuke Yamamoto, Kei Seguchi, Masaru Wada, Hiroshi Fujita, Hideo J Clin Med Article Background: Acute ischemic stroke (AIS) is a rare but critical complication following ST-elevation myocardial infarction (STEMI). The risk of AIS or transient ischemic attack (TIA) may be amplified by invasive procedures, including primary percutaneous coronary intervention (PCI). This study aimed to investigate the factors associated with in-hospital AIS/TIA in patients with STEMI who required primary PCI. Methods: We included 941 STEMI patients who underwent primary PCI and divided them into an AIS/TIA group (n = 39) and a non-AIS/TIA group (n = 902), according to new-onset AIS/TIA. The primary interest was to find the factors associated with AIS/TIA by multivariate logistic regression analysis. We also compared clinical outcomes between the AIS/TIA and non-AIS/TIA groups. Results: The incidence of in-hospital deaths was significantly higher in the AIS/TIA group (46.2%) than in the non-AIS/TIA group (6.3%) (p < 0.001). Multivariate analysis revealed that cardiogenic shock (OR 3.228, 95% CI 1.492–6.986, p = 0.003), new-onset atrial fibrillation (AF) (OR 2.280, 95% CI 1.033–5.031, p = 0.041), trans-femoral approach (OR 2.336, 95% CI 1.093–4.992, p = 0.029), use of ≥4 catheters (OR 3.715, 95% CI 1.831–7.537, p < 0.001), and bleeding academic research consortium (BARC) type 3 or 5 bleeding (OR 2.932, 95% CI 1.256–6.846, p = 0.013) were significantly associated with AIS/TIA. Conclusion: In STEMI patients with primary PCI, new-onset AIS/TIA was significantly associated with cardiogenic shock, new-onset AF, trans-femoral approach, the use of ≥4 catheters, and BARC type 3 or 5 bleeding. We should recognize these modifiable and unmodifiable risk factors for AIS/TIA in the treatment of STEMI. MDPI 2023-01-20 /pmc/articles/PMC9917385/ /pubmed/36769488 http://dx.doi.org/10.3390/jcm12030840 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Murakami, Tsukasa
Sakakura, Kenichi
Jinnouchi, Hiroyuki
Taniguchi, Yousuke
Tsukui, Takunori
Watanabe, Yusuke
Yamamoto, Kei
Seguchi, Masaru
Wada, Hiroshi
Fujita, Hideo
Acute Ischemic Stroke and Transient Ischemic Attack in ST-Segment Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention
title Acute Ischemic Stroke and Transient Ischemic Attack in ST-Segment Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention
title_full Acute Ischemic Stroke and Transient Ischemic Attack in ST-Segment Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention
title_fullStr Acute Ischemic Stroke and Transient Ischemic Attack in ST-Segment Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention
title_full_unstemmed Acute Ischemic Stroke and Transient Ischemic Attack in ST-Segment Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention
title_short Acute Ischemic Stroke and Transient Ischemic Attack in ST-Segment Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention
title_sort acute ischemic stroke and transient ischemic attack in st-segment elevation myocardial infarction patients who underwent primary percutaneous coronary intervention
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917385/
https://www.ncbi.nlm.nih.gov/pubmed/36769488
http://dx.doi.org/10.3390/jcm12030840
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