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Determinants and Outcomes of Stroke Following Percutaneous Coronary Intervention by Indication Clinical Sciences
Conclusions— Hemorrhagic and ischemic stroke complications are uncommon, but serious complications can occur after PCI and are independently associated with worse mortality and major adverse cardiovascular events outcomes in both the elective and acute coronary syndrome setting irrespective of stroke type. Our study provides a better understanding of the risk factors and prognosis of stroke after PCI by procedure type, allowing physicians to provide more informed advice around stroke risk after PCI and counsel patients and their families around outcomes if such neurological complications occur.
Source: Stroke - May 22, 2016 Category: Neurology Authors: Myint, P. K., Kwok, C. S., Roffe, C., Kontopantelis, E., Zaman, A., Berry, C., Ludman, P. F., de Belder, M. A., Mamas, M. A., on behalf of the British Cardiovascular Intervention Society and the National Institute for Cardiovascular Outcomes Research Tags: Percutaneous Coronary Intervention, Intracranial Hemorrhage, Ischemic Stroke Clinical Sciences Source Type: research

Stroke in the TOTAL trial: a randomized trial of routine thrombectomy vs. percutaneous coronary intervention alone in ST elevation myocardial infarction
Conclusion Thrombectomy was associated with a significant increase in stroke. Based on these findings, future trials must carefully collect stroke to determine safety in addition to efficacy.
Source: European Heart Journal - September 14, 2015 Category: Cardiology Authors: Jolly, S. S., Cairns, J. A., Yusuf, S., Meeks, B., Gao, P., Hart, R. G., Kedev, S., Stankovic, G., Moreno, R., Horak, D., Kassam, S., Rokoss, M. J., Leung, R. C. M., El-Omar, M., Romppanen, H. O., Alazzoni, A., Alak, A., Fung, A., Alexopoulos, D., Schwalm Tags: Interventional cardiology Source Type: research

Stroke After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction: Timing, Characteristics, and Clinical Outcomes Coronary Artery Disease
Conclusions— Stroke is an infrequent complication in the setting of ST-segment elevation myocardial infarction treated with primary PCI but is associated with increased morbidity and mortality. Studies to determine mechanisms that may be responsible for strokes that occur >48 hours from primary PCI are warranted. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00091637.
Source: Circulation: Cardiovascular Interventions - April 16, 2013 Category: Cardiology Authors: Guptill, J. T., Mehta, R. H., Armstrong, P. W., Horton, J., Laskowitz, D., James, S., Granger, C. B., Lopes, R. D. Tags: Coronary Artery Disease Source Type: research

Stroke following percutaneous coronary intervention: type-specific incidence, outcomes and determinants seen by the British Cardiovascular Intervention Society 2007-12
Conclusions Incident ischaemic stroke complications have increased over time, whilst haemorrhagic stroke complications have decreased, driven through changes in clinical, procedural, drug-treatment, and demographic factors. Both ischaemic and haemorrhagic strokes are rare but devastating complications with high 30-day mortality and in-hospital MACE rates.
Source: European Heart Journal - July 1, 2015 Category: Cardiology Authors: Kwok, C. S., Kontopantelis, E., Myint, P. K., Zaman, A., Berry, C., Keavney, B., Nolan, J., Ludman, P. F., de Belder, M. A., Buchan, I., Mamas, M. A., on behalf of the British Cardiovascular Intervention Society and the National Institute for Cardiovascul Tags: Interventional cardiology Source Type: research

Glycoprotein IIb-IIIa inhibitors for acute ischaemic stroke.
CONCLUSIONS: The available trial evidence showed that, for individuals with acute ischaemic stroke, GP IIb-IIIa inhibitors are associated with a significant risk of intracranial haemorrhage with no evidence of any reduction in death or disability in survivors. These data do not support their routine use in clinical practice. The conclusion is driven by trials of Abciximab, which contributed 89% of the total number of study participants considered. PMID: 24609741 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 8, 2014 Category: Journals (General) Authors: Ciccone A, Motto C, Abraha I, Cozzolino F, Santilli I Tags: Cochrane Database Syst Rev Source Type: research

Neuroimaging patterns of ischemic stroke after percutaneous coronary intervention
Conclusions The vast majority of radiologically‐confirmed ischemic strokes related to PCI are embolic. MCA territory strokes are most common and uniformly fatal when the entire MCA territory is affected. Functional outcomes in survivors of PCI‐stroke are improved when only a single arterial territory is affected. © 2014 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - September 25, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Scott J Hoffman, Alan H. Yee, Joshua P. Slusser, Charanjit S. Rihal, David R. Holmes, Alejandro A. Rabinstein, Rajiv Gulati Tags: Original Studies Source Type: research

Dual antiplatelet therapy after noncardioembolic ischemic stroke or transient ischemic attack: pros and cons.
Authors: Hong KS Abstract Dual antiplatelet therapy simultaneously blocks different platelet activation pathways and might thus be more potent at inhibiting platelet activation and more effective at reducing major ischemic vascular events compared to antiplatelet monotherapy. Aspirin plus clopidogrel dual therapy is now the standard therapy for patients with acute coronary syndrome and for those undergoing percutaneous coronary intervention. However, dual antiplatelet therapy carries an increased risk of bleeding. Patients with ischemic stroke or transient ischemic attack (TIA) are generally older and likely to hav...
Source: Journal of Clinical Neurology - December 2, 2014 Category: Neurology Tags: J Clin Neurol Source Type: research

Safety of percutaneous coronary intervention in patients with acute ischemic stroke/transient ischemic attack and acute coronary syndrome
Conclusions The primary and secondary end points were not enhanced in patients undergoing PCI. Therefore PCI is safe in patients with stroke/TIA and concomitant ACS.
Source: Clinical Research in Cardiology - October 29, 2015 Category: Cardiology Source Type: research

Combination Therapy with Dipyridamole and Clopidogrel for Secondary Stroke Prevention in Aspirin-Intolerant Patients After Myocardial Infarction: Results of a Nationwide Case-Control Study
ConclusionNo differences were observed in the 12-year survival rate between clopidogrel and clopidogrel –dipyridamole groups. The two groups had balanced event-free survival in recurrent stroke, ICH, GI bleeding, and myocardial infarction.
Source: CNS Drugs - January 16, 2019 Category: Neurology Source Type: research

Impact of clopidogrel and potent P2Y 12 -inhibitors on mortality and stroke in patients with acute coronary syndrome or undergoing percutaneous coronary intervention. A systematic review and meta-analysis.
Abstract Administration of a P2Y 12 -receptor antagonist in addition to aspirin is mandatory in patients with acute coronary syndromes (ACS) or undergoing percutaneous coronary intervention (PCI) to reduce the occurrence of thrombotic events; however, their impact on mortality and stroke is unclear. We aimed to evaluate the influence of moderate (clopidogrel) or potent (prasugrel/ticagrelor) P2Y 12 -receptor inhibition on major cardiovascular outcomes among patients with ACS or undergoing PCI. Systematic literature search was performed to find randomised, controlled clinical trials comparing the clinical impact o...
Source: Thrombosis and Haemostasis - January 8, 2013 Category: Hematology Authors: Aradi D, Komócsi A, Vorobcsuk A, Serebruany VL Tags: Thromb Haemost Source Type: research

Direct oral anticoagulants in the secondary prevention of stroke and transient ischemic attack in patients with atrial fibrillation
Abstract In patients with non-valvular atrial fibrillation (NVAF) and history of transient ischemic attack (TIA) or stroke, the rate of vascular events is higher in comparison to patients without history of stroke or TIA. A meta-analysis of direct oral anticoagulants (DOACs) studies, including only patients with history of stroke or TIA, report a significant reduction of 15 % in the rates of composite of stroke and systemic embolism in patients treated with DOACs, compared to those treated with warfarin. Furthermore, a reduction of 14 % for major bleeding, as well as a 56 % reduction for hemorrhagic stroke over...
Source: Internal and Emergency Medicine - April 11, 2015 Category: Emergency Medicine Source Type: research

Cardioembolic Stroke - Postmyocardial Infarction Stroke
Ischemic stroke following acute myocardial infarction (AMI) is a rare but serious complication due to left ventricular thrombus formation and atrial fibrillation. Early revascularization of the culprit coronary lesion is essential. Treatment trends may affect the risk. Conversely, the greater use of antiplatelet agents to reduce the risk of ischemic stroke could increase the risk of hemorrhagic stroke. The risk of stroke after AMI has decreased significantly with more use of percutaneous coronary intervention and antithrombotic therapies in the acute setting, and statins, antihypertensive medications, and dual antiplatelet...
Source: Cardiology Clinics - March 12, 2016 Category: Cardiology Authors: Marius Hornung, Jennifer Franke, Sameer Gafoor, Horst Sievert Source Type: research

Cardioembolic Stroke and Postmyocardial Infarction Stroke
Ischemic stroke following acute myocardial infarction (AMI) is a rare but serious complication due to left ventricular thrombus formation and atrial fibrillation. Early revascularization of the culprit coronary lesion is essential. Treatment trends may affect the risk. Conversely, the greater use of antiplatelet agents to reduce the risk of ischemic stroke could increase the risk of hemorrhagic stroke. The risk of stroke after AMI has decreased significantly with more use of percutaneous coronary intervention and antithrombotic therapies in the acute setting, and statins, antihypertensive medications, and dual antiplatelet...
Source: Cardiology Clinics - March 11, 2016 Category: Cardiology Authors: Marius Hornung, Jennifer Franke, Sameer Gafoor, Horst Sievert Source Type: research

Low Incidence of Ischemic Stroke Associated With Thrombus Aspiration in STEMI Patients Undergoing Primary PCI
CONCLUSIONS: Very low stroke rates immediately post STEMI were seen in patients undergoing TA and PPCI in this real-world study. TA can be performed safely in STEMI patients undergoing PPCI with a short-term stroke risk equivalent to risk without TA. Further studies may be needed to explain the increased incidence of late stroke noted after TA and elucidate causative mechanisms.PMID:34433694
Source: The Journal of Invasive Cardiology - August 26, 2021 Category: Cardiology Authors: Siddharth J Trivedi Mark J Cooper Andrew T L Ong A Robert Denniss Source Type: research

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