Contemporary Trends in Stroke complicating Cardiac Catheterization: Contemporary Trends in Stroke complicating Cardiac Catheterization

BACKGROUND: Stroke remains an important complication of diagnostic cardiac catheterization and percutaneous coronary intervention and is associated with high rates of in-hospital mortality. AIMS: We sought to evaluate the incidence of stroke over a ten-year period and assess the long-term influence of stroke following cardiac catheterization and percutaneous coronary intervention (PCI) on functional outcomes, based on modified Rankin score (mRS), and mortality. METHODS: The study was performed using a case control design in a single tertiary referral centre. Patients were identified by correlating those patients undergoing cardiac catheterization between October 2006 and December 2016 with patients who underwent neuroimaging within 7 days to identify possible cases of suspected stroke or TIA. RESULTS: A total of 21510 patients underwent cardiac catheterization during the study period. Sixty patients (0.28%) experienced stroke or TIA. Compared to control patients, those who patients who did experience cerebral ischaemic events were older (70.5 vs 64 years; p<0.001), with higher rates of atrial fibrillation, hypertension and diabetes mellitus. Stroke complicating cardiac catheterization was associated with an increased risk of readmission, with a significantly higher hazard of readmission for stroke noted. Despite minimal functional impairment based on mRS, stroke was associated with a significant risk of early and cumulative mortality. Stroke incidence remained stable over the study period despite changes in procedural practice. CONCLUSIONS: The incidence and functional severity of stroke remains low despite evolving procedural practice with a stable incidence over time despite changes in procedural practice, however, post-procedural stroke confirms an increased mortality hazard. This article is protected by copyright. All rights reserved.