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ȣ - 540749 211 |
Impact of Prior History of Cerebral Infarction versus Intracerebral Hemorrhage on Clinical Outcomes in Patients Undergoing Percutanoeus Coronary Intervention with Drug-eluting Stents |
을지병원 심장내과 ¹ 고려대학교 구로병원 심혈관센터² |
박지영¹,², 나승운 ² 최재웅¹ , 유승기¹ , Kanhaiya L. Poddar ² , Meera Kumari ² , 최병걸 ² , 김연경 ², 나진오 ², 최철웅 ² , 임홍의 ², 김진원 ², 김응주 ², 박창규 ², 서홍석 ², 오동주² |
Background Coronary artery disease is known to be a main cause of death in most patients (pts) who had stroke. However, there have been limited data of the angiographic and long term clinical outcomes in pts undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) who had history of cerebral infarction or intracerebral hemorrhage.Methods The study population consisted of 131 consecutive patients (pts) who had prior history of stroke and underwent PCI with DESs from November 2005 to June 2008. We compared angiographic and major clinical outcomes of pts with prior history of cerebral infarction (CI, n=105 pts) to those of pts with intracerebral hemorrhage (ICH, n=25 pts) up to 2 years. Results The baseline clinical and procedural characteristics were similar between the two groups. Six-month angiographic outcomes showed that pts of CI group had higher restenosis % and late loss than those of ICH group. Despite the lower incidence of cardiac death, pts of CI group showed higher cumulative target vessel revascularization (TVR)-major adverse cardiac events (MACEs) and trend toward higher incidence of total MACE up to 2 years compared with those of ICH group (Table). However, CI was not an independent predictor of TVR-MACE (Adjusted OR: 1.689, 95% CI: 0.882-3.236, p-value=0.114). Conclusions In our study, CI was associated with worse mid-term angiographic and long-term clinical outcomes compared with those of ICH at least up to 2 years, reflecting similar pathogenesis of advanced atherosclerotic cardio-cerebrovascular disease.
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Table: Six-month Angiographic and 2-year clinical outcomes
Variable, n (%) |
Cerebral infarction group (n=105 pts,1138 lesions) |
Intracerebral hemorrhage group
(n= 25 pts, 198 lesions) |
P value |
Binary restenosis |
9 (22.0) |
0 (0.0) |
0.176 |
Restenosis percent, % |
31.10 ± 28.00 |
18.81 ± 12.70 |
0.028 |
Late loss, mm |
0.71 ± 0.85 |
0.28 ± 0.44 |
0.022 |
Cardiac death |
2 (3.7) |
2 (10.5) |
0.001 |
Q-wave MI |
5 (0.9) |
6 (1.1) |
0.770 |
TLR |
6 (11.1) |
0 (0.0) |
0.177 |
TVR |
7 (13.5) |
0 (0.0) |
0.178 |
TVR-MACE |
19 (23.8) |
0 (0.0) |
0.024 |
Total MACE |
18(33.3) |
2 (10.5) |
0.074 |
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