Cerebrovascular accidents after percutaneous coronary interventions from 2002 to 2014: Incidence, outcomes, and associated variables. (Record no. 2562)

000 -LEADER
fixed length control field 04887nam a22007577a 4500
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 160715s20162016 xxu||||| |||| 00| 0 eng d
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
Classification number 26856219
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 0002-8703
190 ## -
-- Didier R
190 ## -
-- Gaglia MA Jr
190 ## -
-- Koifman E
190 ## -
-- Kiramijyan S
190 ## -
-- Negi SI
190 ## -
-- Omar AF
190 ## -
-- Gai J
190 ## -
-- Torguson R
190 ## -
-- Pichard AD
190 ## -
-- Waksman R
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Didier, Romain
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Gaglia, Michael AJ
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Koifman, Edward
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Kiramijyan, Starkis
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Negi, Smita I
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Omar, Al Fazir
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Gai, Jiaxing
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Torguson, Rebecca
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Pichard, Augusto D
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Waksman, Ron
245 ## - TITLE STATEMENT
Title Cerebrovascular accidents after percutaneous coronary interventions from 2002 to 2014: Incidence, outcomes, and associated variables.
251 ## -
-- American Heart Journal. 172:80-7, 2016 Feb.
252 ## -
-- Am Heart J. 172:80-7, 2016 Feb.
253 ## -
-- American heart journal
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Date of publication, distribution, etc. 2016
501 ## - WITH NOTE
With note Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520 ## - SUMMARY, ETC.
Summary, etc. BACKGROUND: Cerebrovascular accident (CVA) and transient ischemic attack (TIA) related to percutaneous coronary intervention (PCI) are relatively rare complications, but they are associated with high morbidity and mortality. Given the evolution of both CVA risk and PCI techniques over time, this study was conducted to evaluate trends in CVA and TIA associated with PCI and to identify variables associated with neurologic events.
520 ## - SUMMARY, ETC.
Summary, etc. METHODS: Consecutive patients undergoing PCI at the Washington Hospital Center between January 2002 and June 2015 were included. Prespecified data were prospectively collected, including baseline and procedural characteristics, in-hospital outcomes, and 1-year mortality. The subjects who had a CVA or TIA during or immediately after PCI were compared with those without procedure-associated CVA or TIA.
520 ## - SUMMARY, ETC.
Summary, etc. RESULTS: Overall, 25,626 patients were included in the study. The mean age was 65.0 +/- 12.4 years, 16,949 (65.2%) were male, and 7,436 (28.6%) were African American. From 2002 to 2015, 110 neurologic events post-PCI were diagnosed (0.43%); this included 86 CVAs (0.34%) and 24 TIAs (0.09%). The annual rate of postprocedural neurologic events was 0.42% +/- 0.12%. There were significant changes in baseline risk factors over time, with increasing age, incidence of insulin-dependent diabetes, and chronic kidney disease. Patients with neurologic events were more often African American (43.6% vs 28.6%, P < .001) with prior history of CVA (24.5% vs 7.8%, P < .001), chronic renal insufficiency (26.6% vs 15.2%, P < .001), and insulin-dependent diabetes (19.1% vs 12.4%, P = .03). Acute myocardial infarction (56% vs 30.4%, P < .001) and cardiogenic shock (20.2% vs 3%, P < .001) were also more common among patients with neurologic events post-PCI. After multivariable adjustment, use of an intraaortic balloon pump was strongly associated with neurologic events (odds ratio [OR] 4.9, 95% CI 2.7-8.8, P < .001), as was prior CVA (OR 2.4, 95% CI 1.4-4.4, P = .002) and African American race (OR 2.4, 95% CI 1.5-3.9, P < .001); there was a borderline association with the use of a thrombus extraction device (OR 1.7, 95% CI 0.9-3.2, P = .09). In-hospital mortality (20.0% vs 1.5%, P < .001) and 1-year mortality (45.0% vs 7.3%, P < .001) were also much higher in patients with neurologic events.
520 ## - SUMMARY, ETC.
Summary, etc. CONCLUSION: Neurologic events post-PCI are associated with markedly worse in-hospital outcomes. The incidence of CVA and TIA post-PCI, however, remained stable over the last 12 years despite an increase in risk factors for CVA.Copyright © 2015 Elsevier Inc. All rights reserved.
546 ## - LANGUAGE NOTE
Language note English
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Geographic name MedStar Heart & Vascular Institute
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Aged
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element District of Columbia/ep [Epidemiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Female
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Follow-Up Studies
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Forecasting
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Hospital Mortality/td [Trends]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Humans
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Incidence
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Male
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Myocardial Ischemia/su [Surgery]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Odds Ratio
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Percutaneous Coronary Intervention/ae [Adverse Effects]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Prognosis
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Registries
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Retrospective Studies
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Risk Factors
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Stroke/ep [Epidemiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Stroke/et [Etiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Time Factors
657 ## - INDEX TERM--FUNCTION
Function Journal Article
657 ## - INDEX TERM--FUNCTION
Function Observational Study
857 ## -
-- http://dx.doi.org/10.1016/j.ahj.2015.10.019
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0002870315006481?returnurl=null&referrer=null
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection code Permanent Location Current Location Date acquired Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 2016-07-15 26856219 2016-07-15 2016-07-15 Journal Article

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