Naslov
Peripheral vascular disease independently predicts periprocedural adverse cerebrovascular events among patients with acute myocardial infarction undergoing percutaneous revascularization: analysis of 2,810,728 hospitalizations in the US

Autori
Borovac, Josip Anđelo ; Mamas, Mamas Andreas

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstracts of the 4th International Conference of the ESC Council on Stroke / - , 2021, 42-42

Skup
4th International Conference of the ESC Council on Stroke (ESC Heart & Stroke 2021 )

Mjesto i datum
Online, 02.06.2021. - 04.06.2021

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Acute coronary syndrome ; Myocardial infarction ; PCI ; Peripheral vascular disease ; Stroke ; Ischemic cerebrovascular events ; Percutaneous coronary intervention ; Periprocedural stroke ; Transient ischemic attack ; TIA ; Hospital outcomes

Sažetak
Background: Peripheral vascular disease (PVD) is in tight association with atherosclerosis of cerebral and coronary vascular territories and portends a poor prognosis. Complications of PVD might result in limb ischemia and amputation, coronary artery disease (CAD), and stroke. The association of existing PVD with adverse periprocedural cerebrovascular events in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) is poorly understood. Purpose: In the present study, we underwent to 1) examine the incidence of PVD in patients with AMI undergoing PCI, 2) examine the rates of adverse periprocedural cerebrovascular events in patients with PVD vs. without PVD, and 3) quantify the predictive role of PVD with Derespect to periprocedural adverse cerebrovascular events after adjustment for relevant baseline covariates in the multivariable regression model. Methods: We retrospectively analyzed 2, 810, 728 patients hospitalized for ST-elevation myocardial infarction (STEMI) and non-ST- elevation myocardial infarction (NSTEMI) who were treated with PCI during the 2004-2014 period. Data were obtained from the United States National Inpatient Sample (NIS) database by using the International Classification of Diseases, Ninth Revision (ICD-9) diagnostic and procedural codes. The primary endpoint of interest was the in-hospital composite of periprocedural adverse cerebrovascular events consisting of ischemic/hemorrhagic stroke and TIA events. Multivariable regression analysis adjusted for relevant baseline covariates was used to determine the relationship of PVD with the adverse periprocedural cerebrovascular events. The regression model was adjusted for prespecified covariates including age, sex, emergent PCI setting, type of ACS, atrial fibrillation (AF), diabetes mellitus (DM), arterial hypertension (AH), smoking, hypercholesterolemia, chronic kidney disease (CKD), history of stroke/TIA, and history of myocardial infarction (MI). For this analysis, odds ratios (OR) and 95% confidence intervals (95% CI were reported) Results: The mean age of the analyzed population was 62.9 ± 13.1 years and 68% were men. A total of 1, 439, 607 patients (51.2%) were admitted for NSTEMI while 1, 371, 121 (48.8%) were admitted for STEMI. About 10% of the whole sample had AF, 30.2% had DM, 65.4% had hypertension, 9.1% had a positive history for MI while 2.9% had a positive history of the cerebrovascular event (previous ischemic/hemorrhagic stroke or TIA). The average incidence of PVD during the examined period was 8.6% (N=242, 994) while the crude rate of in-hospital periprocedural stroke/TIA was 2.4%. The rate of periprocedural stroke/TIA was significantly higher in patients with PVD vs. patients without PVD (7.5% vs. 1.9%, p<0.0001). Likewise, patients with AF had a two-fold increase in the rate of adverse cerebrovascular events compared to non-AF patients (4.4% vs. 2.2%, p<0.0001). In the multivariable regression model adjusted for prespecified covariates, PVD was independently associated with a threefold increase in the likelihood of periprocedural stroke/TIA (OR 2.99, 95% CI 2.90-3.11, p<0.0001). Conclusion: Among patients with AMI undergoing PCI, those with peripheral vascular disease are three times more likely to experience adverse periprocedural cerebrovascular events during the hospital stay.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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