OBJECTIVES: To examine the frequency of cerebrovascular complications among patients receiving abciximab (AB) undergoing PCI with prior intracranial hemorrhage (ICH) or recent (< 2 years) ischemic strokes. BACKGROUND: AB improves clinical outcomes in high-risk patients undergoing percutaneous coronary intervention (PCI); however, the safety of AB in patients with prior stroke has not been adequately studied. METHODS: A database review of 7,244 consecutive PCIs, from 7/97 to 10/01, identified 6,190 PCIs performed with AB among which 515 interventions were performed in patients with prior stroke history [ICH or recent ischemic stroke, (n = 101) and remote (> 2 years) ischemic stroke, (n = 414)]. RESULTS: The post-PCI stroke rate was significantly higher in patients with prior stroke (2.06% vs. 0.35%, p < 0.001 for all stroke; 0.38% vs. 0.03%, p = 0.023 for ICH). The incidence of ICH among the AB-treated group was 0.065%; a history of prior stroke did not increase the incidence of ICH in the AB-treated group (0.39% vs. 0.0%, p = ns). Moreover, the post-PCI stroke rate was similar between the prior ICH or recent ischemic stroke-group and remote ischemic stroke-group (2 vs. 1.9%; OR: 1.03; 95% CI: 0.21-4.90; p = ns for all strokes; 2% vs. 1.5%; OR: 1.4; 95% CI: 0.27-6.91; p = ns for ischemic stroke). Importantly, no ICH occurred in patients with recent ischemic or any prior ICH stroke. CONCLUSIONS: Abciximab, in addition to aspirin, heparin and ADP-inhibitors does not increase the risk of stroke in patients with prior stroke undergoing PCI.
OBJECTIVES: To examine the frequency of cerebrovascular complications among patients receiving abciximab (AB) undergoing PCI with prior intracranial hemorrhage (ICH) or recent (< 2 years) ischemic strokes. BACKGROUND: AB improves clinical outcomes in high-risk patients undergoing percutaneous coronary intervention (PCI); however, the safety of AB in patients with prior stroke has not been adequately studied. METHODS: A database review of 7,244 consecutive PCIs, from 7/97 to 10/01, identified 6,190 PCIs performed with AB among which 515 interventions were performed in patients with prior stroke history [ICH or recent ischemic stroke, (n = 101) and remote (> 2 years) ischemic stroke, (n = 414)]. RESULTS: The post-PCI stroke rate was significantly higher in patients with prior stroke (2.06% vs. 0.35%, p < 0.001 for all stroke; 0.38% vs. 0.03%, p = 0.023 for ICH). The incidence of ICH among the AB-treated group was 0.065%; a history of prior stroke did not increase the incidence of ICH in the AB-treated group (0.39% vs. 0.0%, p = ns). Moreover, the post-PCI stroke rate was similar between the prior ICH or recent ischemic stroke-group and remote ischemic stroke-group (2 vs. 1.9%; OR: 1.03; 95% CI: 0.21-4.90; p = ns for all strokes; 2% vs. 1.5%; OR: 1.4; 95% CI: 0.27-6.91; p = ns for ischemic stroke). Importantly, no ICH occurred in patients with recent ischemic or any prior ICH stroke. CONCLUSIONS:Abciximab, in addition to aspirin, heparin and ADP-inhibitors does not increase the risk of stroke in patients with prior stroke undergoing PCI.
Authors: W D Weaver; R J Simes; A Betriu; C L Grines; F Zijlstra; E Garcia; L Grinfeld; R J Gibbons; E E Ribeiro; M A DeWood; F Ribichini Journal: JAMA Date: 1997-12-17 Impact factor: 56.272
Authors: Shmuel Fuchs; Eugenio Stabile; Timothy D Kinnaird; Gary S Mintz; Luis Gruberg; Daniel A Canos; Ellen E Pinnow; Ran Kornowski; William O Suddath; Lowell F Satler; Augusto D Pichard; Kenneth M Kent; Neil J Weissman Journal: Circulation Date: 2002-07-02 Impact factor: 29.690
Authors: C L Grines; K F Browne; J Marco; D Rothbaum; G W Stone; J O'Keefe; P Overlie; B Donohue; N Chelliah; G C Timmis Journal: N Engl J Med Date: 1993-03-11 Impact factor: 91.245
Authors: D L Fischman; M B Leon; D S Baim; R A Schatz; M P Savage; I Penn; K Detre; L Veltri; D Ricci; M Nobuyoshi Journal: N Engl J Med Date: 1994-08-25 Impact factor: 91.245
Authors: A Schömig; F J Neumann; A Kastrati; H Schühlen; R Blasini; M Hadamitzky; H Walter; E M Zitzmann-Roth; G Richardt; E Alt; C Schmitt; K Ulm Journal: N Engl J Med Date: 1996-04-25 Impact factor: 91.245