LAUSR

BACKGROUND Stroke related to percutaneous coronary interventions (PCIs) is an infrequent complication, potentially life-threatening and often leading to serious disability. AIMS The study aim is to assess the relationship between the type of coronary procedure and incidence of stroke as well as its predictors. METHODS This retrospective analysis was performed on prospectively collected data gathered in the Polish National Registry of Percutaneous Coronary Interventions (ORPKI) between January 2014 and December 2019, and included 1177 161 coronary procedures. Among them, 650,674 patients underwent isolated diagnostic coronary angiography (DCA) and 526,487 PCI. Stroke was diagnosed in 157 patients (0.013%), of which 100 (0.015%) during DCA and 57 (0.011%) during PCI. Multivariable logistic regression analysis was performed to separate predictors of stroke in patients undergoing coronary angiography and PCI. RESULTS The percentage of patients with periprocedural stroke was higher in a group treated with isolated DCA during the analysed time. Among predictors of stroke in patients undergoing DCA we confirmed prior stroke (P <0.001), contrast amount (P = 0.007), femoral access (P = 0.002), unfractionated heparin use (P = 0.01), direct transport (P = 0.04), older age (P <0.001) and multi-vessel disease (P <0.001). While for PCI ± DCA, these were: prior stroke (P <0.001), thrombolysis (P = 0.003), treatment with bivalirudin (P <0.001) and acetyl-salicylic acid loading during PCI (P = 0.003). CONCLUSIONS Based on the large national registry, PCI ± DCA is associated with fewer risk factors and lower rate of periprocedural strokes than isolated DCA.