Temporal Trends in Risk Factors of Periprocedural Stroke in Patients Undergoing Percutaneous Coronary Intervention: Insights from the ACC NCDR CathPCI Registry.

Periprocedural stroke complicates up to 1% of patients undergoing percutaneous coronary intervention (PCI) and is associated with increased morbidity, mortality, and subsequent health care resource utilization. 1 Aggarwal A Dai D Rumsfeld JS Klein LW Roe MT American College of Cardiology National Cardiovascular Data Registry. Incidence and predictors of stroke associated with percutaneous coronary intervention. Am J Cardiol. 2009; 104: 349-353 Abstract Full Text Full Text PDF PubMed Scopus (79) Google Scholar , 2 Alkhouli M Alqahtani F Tarabishy A Sandhu G Rihal CS. Incidence, predictors, and outcomes of acute ischemic stroke following percutaneous coronary intervention. JACC Cardiovasc Interv. 2019; 12: 1497-1506 Crossref PubMed Scopus (43) Google Scholar , 3 Carrena O Young R Tarrar IH Nelson AJ Woidyla D Wang TY Mehta RH. Trends in the incidence and fatality of peripercutaneous coronary intervention stroke. J Am Coll Cardiol. 2022; 80: 1772-1774 Crossref PubMed Scopus (0) Google Scholar , 4 Shoji S Kohsaka S Kumamaru H Sawano M Shiraishi Y Ueda I Noma S Suzuki M Numasawa Y Hayashida K Yuasa S Miyata H Fukuda K. Stroke after percutaneous coronary intervention in the era of transradial intervention. Circ Cardiovasc Interv. 2018; 11e006761 Crossref PubMed Scopus (31) Google Scholar , 5 Yamamoto K Natsuaki M Morimoto T Shiomi H Matsumura-Nakano Y Nakatsuma K Watanabe H Yamamoto E Kato E Fuki M Yamaji K Nishikawa R Nagao K Takeji Y Watanabe H Tazaki J Watanabe S Saito N Yamazaki K Soga Y Komiya T Ando K Minatoya K Furukawa Y Nakagawa Y Kadota K Kimura T CREDO-Kyoto PCI/CABG Registry Cohort-3 InvestigatorsPeriprocedural Stroke after Coronary revascularization (from the CREDO-Kyoto PCI/CABG Registry Cohort-3). Am J Cardiol. 2021; 142: 35-43 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar Contemporary reports suggest that despite iterative procedural evolution in PCI (e.g., smaller catheters, radial access, and potent pharmacotherapy), periprocedural stroke rates have not improved over the last few years, with our recent analysis suggesting these rates may be in fact be rising, likely as a result of an increasingly co-morbid population 3 Carrena O Young R Tarrar IH Nelson AJ Woidyla D Wang TY Mehta RH. Trends in the incidence and fatality of peripercutaneous coronary intervention stroke. J Am Coll Cardiol. 2022; 80: 1772-1774 Crossref PubMed Scopus (0) Google Scholar and higher procedural complexity. 2 Alkhouli M Alqahtani F Tarabishy A Sandhu G Rihal CS. Incidence, predictors, and outcomes of acute ischemic stroke following percutaneous coronary intervention. JACC Cardiovasc Interv. 2019; 12: 1497-1506 Crossref PubMed Scopus (43) Google Scholar However, there is a paucity of data providing insights into how patient and procedural risks have changed over time, which may have implications for interventions aimed to reduce peri-PCI stroke risk.