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Ischaemic heart disease (MI and CVA)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Stroke is a rare but potentially devastating complication of acute myocardial infarction

  • stroke occurs in approximately 1per cent of patients following percutaneous coronary intervention (PCI)
  • study evidence shows (1)
    • stroke occurred in 1.3% of primary patients with PCI
      • a third of strokes were ischemic (n=23; 33%), 12% (n=8) were hemorrhagic, and the remaining 55% (n=38) were of uncertain type
      • median (25th, 75th percentile) time of stroke occurrence was 6 (3, 14) days
      • 43% of strokes occurred within 48 hours of PCI, and all hemorrhagic strokes occurred within 48 hours
      • stroke was associated with an increased risk of 90-day death (unadjusted hazard ratio [HR], 8.0; 95% confidence interval [CI], 4.8-13.5), congestive heart failure (unadjusted HR, 3.2; 95% CI, 1.3-7.8), and 30-day hospital readmission (unadjusted HR, 3.2; 95% CI, 2.0-5.1)

    • all hemorrhagic strokes occurred within 48 hours of primary PCI, whereas ischemic strokes tended to occur beyond 48 hours
    • because most of the strokes occurred >48 hours after primary PCI, not all strokes after primary PCI seem to be procedure-related and, therefore, other mechanisms might be responsible for these later events

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