RISK-FACTORS OF STROKE AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

Objective: to determine possible risk factors of a stroke after percut aneous transluminal coronary angioplasty (PTCA). Design: this is a ret rospective evaluation of a consecutive group of 4088 patients undergoi ng PTCA between 1988 and 1995. We have studied the incidence, clinical characteristics, risk factors, and outcome. Results: seven patients, six males and one female (0.17%) developed a stroke after this procedu re. In comparison with the control group, the stroke group did not dif fer regarding age or gender. The existence of a stroke (six located in the brain, and one in the spinal cord), represented 1.24% of all comp lications (P < 0.001), and 5% of all deaths (P < 0.01) of PTCA. Three patients developed TIA, two patients developed hemorrhagic strokes tin which they received previous thrombolytic therapy), and the other two patients suffered from an ischemic stroke. The statistically signific ant risk factors of a stroke after PTCA included: intracoronary thromb olytic therapy (P < 0.01), hypercholesterolemia (P<0.001) and a prior PTCA (P < 0.05). Conclusions: although these procedural complications are infrequent, they are usually serious and important risk factors wh ich could be identified prior to the procedure. These risk factors wou ld allow identification of patients who are prone to a stroke after PT CA. Intracranial hemorrhage occurred only after thrombolytic therapy, and the factors related to hemorrhagic strokes were probably different from those predisposed to ischemic strokes and TIA. (C) 1998 Lippinco tt Williams & Wilkins.