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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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. |
format | Online Article Text |
id | pubmed-9917385 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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