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NGHIÊN CỨU LÂM SÀNG Issue: Số 105 năm 2023 BỆNH MẠCH VÀNH

Stroke events within 4 years in patients after coronary stenting intervention at Thanh Hoa Provincial General Hospital

Nguyễn Văn Hiệp: Bệnh viện Đa khoa tỉnh Thanh Hóa; Lê Văn Cường: Bệnh viện Đa khoa tỉnh Thanh Hóa; Nguyễn Lân Hiếu: Bệnh viện Trường Đại học Y Hà Nội;
Published: May 31, 2023
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Abstract

Objective: (1) Survey of stroke events within 4 years in patients after coronary stenting intervention at Thanh Hoa Provincial General Hospital. (2) Learn some risk factors related to stroke in the group of patients mentioned above.

Materials and method: 1019 patients underwent percutaneous coronary intervention (PCI) at the Cardiovascular Intervention Unit of Thanh Hoa Provincial General Hospital from January 1, 2018 to December 1, 2022, and were followed up to December 31, 2022.

Results: There are 36 cases of stroke accounting for 3,6%; In which Cerebral Infarction 2,5%; Transient Ischemic Attack (TIA) 1,1%; There were no cases of Intracranial hemorrhage. The ratio of male/female in the stroke group is 2,2/1, the no stroke group is 2,5/1; The average age of the stroke and no stroke group is: 73,83+8,90, respectively; 68,93+9,56;

- In terms of risk factors in stroke group: Hyperlipidemia 75%; Diabetes mellitus 41,7%; Hypertension 94,4%; Smoking 47,2%; BMI > 25 accounts for 27,8%; Creatinine clearance < 40 ml/min accounted for 33,3%; Carotis stenosis > 50% accounted for 22,2%; EF < 40% accounts for 8,3%; COPD 8,3%; Gout 11,1%, Cancer 2,8%, Atrial fibrillation 8,3%.

- In terms of intervention characteristics: 7% had a cerebral stroke in 185 STEMI cases; 3% in 165 cases of NSTEMI; 3,3% in 426 Unstable angina cases; and 1,6%  in 243 cases of Stable ischemic heart disease. Leftmain intervention rate 2,5%; RCA 32,7%; LCX 19,5%, LAD 45,3%.

- Factors that increase the risk of stroke: Age > 75; Hypertension; Diabetes mellitus; Hyperlipidemia; BMI > 25; Smoke; Heart failure EF < 40%; Atrial fibrillation; Creatinine clearance < 40 ml/min; Carotid stenosis > 50%; Leftmain intervention; STEMI

- Factors that increase the risk of cerebral infarction: Age > 75; Female; Hypertension; Diabetes mellitus; Hyperlipidemia; BMI > 25; Smoke; Heart failure EF < 40%; Atrial fibrillation; Creatinine clearance < 40 ml/min; Carotid stenosis > 50%; Leftmain intervention; STEMI

- Factors that increase the risk of TIA: Age > 75; Smoke; Creatinine clearance < 40 ml/min; Carotid stenosis > 50%; leftmain intervention

Conclusion: The rate of post-PCI ischemic stroke increased significantly in recent years. The rate of stroke in the study accounted for 3,6%; In which Cerebral Infarction 2,5%; TIA 1,1%, no cases of Intracranial hemorrhage. There are many risk factors that increase stroke events such as Age > 75; Hypertension; Diabetes mellitus; Hyperlipidemia; BMI > 25; Smoke; Heart failure EF < 40%; Atrial fibrillation; Creatinine clearance < 40 ml/min; Carotid stenosis > 50%, factors related to intervention such as leftmain intervention, intervention on patients STEMI. More studies with larger sample sizes and multicenters are needed to further and more systematically evaluate the factors that increase stroke events, thereby developing effective strategies to reduce this event.

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