PMID- 20128147
OWN - NLM
STAT- MEDLINE
DCOM- 20100309
LR  - 20170511
IS  - 0001-5385 (Print)
IS  - 0001-5385 (Linking)
VI  - 64
IP  - 6
DP  - 2009 Dec
TI  - Ischaemic stroke complicating primary percutaneous coronary intervention in 
      patients with ST elevation myocardial infarction.
PG  - 729-34
AB  - OBJECTIVE: We sought to determine the in-hospital incidence and predictors of 
      ischaemic stroke in patients with ST elevation myocardial infarction (STEMI) 
      undergoing primary percutaneous coronary intervention (PCI). METHODS: We reviewed 
      2638 consecutive patients undergoing 2722 pimary PCI procedures for STEMI during 
      in-hospital stay. Stroke was defined as any new focal neurological deficit 
      lasting > or =24 h, occurring anytime during or after PCI until discharge. 
      Patients with haemorrhagic stroke were excluded. Clinical characteristics and 
      in-hospital outcome were analysed regarding ischaemic stroke in patients 
      undergoing primary PCI. RESULTS: Ischaemic stroke was observed in 20 of the 2722 
      procedures, an incidence of 0.73%. Patients with ischaemic stroke were older than 
      patients without stroke (mean age 67 +/- 9.6 vs. 56.6 +/- 11.8, P < 0.001). 
      Compared to patients without stroke, female gender, diabetes and hypertension 
      were more prevalent in patients with stroke. Ischaemic stroke was found to be a 
      powerful independent predictor of in-hospital cardiovascular mortality (odds 
      ratio [OR] 6.32, 1.15-34.7; P < 0.001). Left ventricular ejection fraction (LVEF) 
      < 35% (OR 3.13, P = 0.04), contrast-induced nephropathy (OR 2.91, P = 0.04) and 
      tirofiban use (OR 0.23, P = 0.02) were the independent predictors for in-hospital 
      ischaemic stroke. CONCLUSIONS: The present study shows that the incidence of 
      ischaemic stroke in patients undergoing PCI for STEMI is higher and ischaemic 
      stroke increases in-hospital mortality in these patients. Moreover, LVEF < 35% 
      and contrast-induced nephropathy were independent predictors of ischaemic stroke, 
      whereas tirofiban use demonstrated a protective effect to this potentially 
      catastrophic complication.
FAU - Ergelen, Mehmet
AU  - Ergelen M
AD  - Dept. of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Centre, 
      Training and Research Hospital, Istanbul, Turkey. drmerg@hotmail.com
FAU - Gorgulu, Sevket
AU  - Gorgulu S
FAU - Uyarel, Huseyin
AU  - Uyarel H
FAU - Norgaz, Tugrul
AU  - Norgaz T
FAU - Ayhan, Erkan
AU  - Ayhan E
FAU - Akkaya, Emre
AU  - Akkaya E
FAU - Ergelen, Rabia
AU  - Ergelen R
FAU - Cicek, Gokhan
AU  - Cicek G
FAU - Ugur, Murat
AU  - Ugur M
FAU - Soylu, Ozer
AU  - Soylu O
FAU - Tezel, Tuna
AU  - Tezel T
FAU - Yekeler, Ibrahim
AU  - Yekeler I
LA  - eng
PT  - Journal Article
PL  - England
TA  - Acta Cardiol
JT  - Acta cardiologica
JID - 0370570
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Brain Infarction/*epidemiology/mortality
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/*therapy
MH  - Retrospective Studies
MH  - Stroke Volume
EDAT- 2010/02/05 06:00
MHDA- 2010/03/10 06:00
CRDT- 2010/02/05 06:00
PHST- 2010/02/05 06:00 [entrez]
PHST- 2010/02/05 06:00 [pubmed]
PHST- 2010/03/10 06:00 [medline]
AID - 10.2143/AC.64.6.2044735 [doi]
PST - ppublish
SO  - Acta Cardiol. 2009 Dec;64(6):729-34. doi: 10.2143/AC.64.6.2044735.