Periprocedural Stroke After Coronary Revascularization (from the CREDO-Kyoto PCI/CABG Registry Cohort-3)

被引：13

作者：

Yamamoto, Ko ^{[1
]}

Natsuaki, Masahiro ^{[2
]}

Morimoto, Takeshi ^{[3
]}

Shiomi, Hiroki ^{[1
]}

Matsumura-Nakano, Yukiko ^{[1
]}

Nakatsuma, Kenji ^{[4
]}

Watanabe, Hiroki ^{[5
]}

Yamamoto, Erika ^{[1
]}

Kato, Eri ^{[1
]}

Fuki, Masayuki ^{[1
]}

Yamaji, Kyohei ^{[6
]}

Nishikawa, Ryusuke ^{[7
]}

Nagao, Kazuya ^{[8
]}

Takeji, Yasuaki ^{[1
]}

Watanabe, Hirotoshi ^{[1
]}

Tazaki, Junichi ^{[1
]}

Watanabe, Shin ^{[1
]}

Saito, Naritatsu ^{[1
]}

Yamazaki, Kazuhiro ^{[9
]}

Soga, Yoshiharu ^{[10
]}

Komiya, Tatsuhiko ^{[11
]}

Ando, Kenji ^{[6
]}

Minatoya, Kenji ^{[9
]}

Furukawa, Yutaka ^{[12
]}

Nakagawa, Yoshihisa ^{[13
]}

Kadota, Kazushige ^{[14
]}

Kimura, Takeshi ^{[1
]}

机构：

[1] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Med, Kyoto, Japan

[2] Saga Univ, Dept Cardiovasc Med, Saga, Japan

[3] Hyogo Coll Med, Dept Clin Epidemiol, Nishinomiya, Hyogo, Japan

[4] Mitsubishi Kyoto Hosp, Dept Cardiol, Kyoto, Japan

[5] Japanese Red Cross Wakayama Med Ctr, Dept Cardiol, Wakayama, Japan

[6] Kokura Mem Hosp, Dept Cardiol, Kitakyushu, Fukuoka, Japan

[7] Shizuoka Prefectural Gen Hosp, Dept Cardiol, Shizuoka, Japan

[8] Osaka Red Cross Hosp, Dept Cardiovasc Ctr, Osaka, Japan

[9] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Surg, Kyoto, Japan

[10] Kokura Mem Hosp, Dept Cardiovasc Surg, Kitakyushu, Fukuoka, Japan

[11] Kurashiki Cent Hosp, Dept Cardiovasc Surg, Kurashiki, Okayama, Japan

[12] Kobe City Med Ctr Gen Hosp, Dept Cardiovasc Med, Kobe, Hyogo, Japan

[13] Shiga Univ Med Sci, Dept Cardiovasc Med, Shiga, Japan

[14] Kurashiki Cent Hosp, Dept Cardiol, Kurashiki, Okayama, Japan

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2021年 / 142卷

关键词：

INTERVENTION; OUTCOMES; SURGERY; RISK; SOCIETY; DISEASE; IMPACT;

D O I：

10.1016/j.amjcard.2020.11.031

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

There is a scarcity of data on incidence, risk factors, especially clinical severity, and long-term prognostic impact of periprocedural stroke after coronary revascularization in contemporary real-world practice. Among 14,867 consecutive patients undergoing first coronary revascularization between January 2011 and December 2013 (percutaneous coronary intervention [PCI]: N = 13258, and coronary artery bypass grafting [CABG]: N = 1609) in the Coronary Revascularization Demonstrating Outcome Study in Kyoto PCI/CABG registry Cohort-3, we evaluated the details on periprocedural stroke. Periprocedural stroke was defined as stroke within 30 days after the index procedure. Incidence of periprocedural stroke was 0.96% after PCI and 2.13% after CABG (log-rank p<0.001). Proportions of major stroke defined by modified Rankin Scale >= 2 at hospital discharge were 68% after PCI, and 77% after CABG. Independent risk factors of periprocedural stroke were acute coronary syndrome (ACS), carotid artery disease, advanced age, heart failure, and end-stage renal disease after PCI, whereas they were ACS, carotid artery disease, atrial fibrillation, chronic obstructive pulmonary disease, malignancy, and frailty after CABG. There was excess long-term mortality risk of patients with periprocedural stroke relative to those without after both PCI and CABG (hazard ratio 1.71 [1.25 to 2.33], and hazard ratio 4.55 [2.79 to 7.43]). In conclusion, incidence of periprocedural stroke was not negligible not only after CABG, but also after PCI in contemporary real-world practice. Majority of patients with periprocedural stroke had at least mild disability at hospital discharge. ACS and carotid artery disease were independent strong risk factors of periprocedural stroke after both PCI and CABG. Periprocedural stroke was associated with significant long-term mortality risk after both PCI and CABG. (C) 2020 Elsevier Inc. All rights reserved.

引用

页码：35 / 43

页数：9

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