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dc.contributor.authorNatsuaki, Masahiro
dc.contributor.authorMorimoto, Takeshi
dc.contributor.authorWatanabe, Hirotoshi
dc.contributor.authorNakagawa, Yoshihisa
dc.contributor.authorFurukawa, Yutaka
dc.contributor.authorKadota, Kazushige
dc.contributor.authorAkasaka, Takashi
dc.contributor.authorHanaoka, Igarashi, Keiichi
dc.contributor.authorKozuma, Ken
dc.contributor.authorTanabe, Kengo
dc.contributor.authorMorino, Yoshihiro
dc.contributor.authorMuramatsu, Toshiya
dc.contributor.authorKimura, Takeshi
dc.contributor.alternative渡部, 宏俊
dc.date.accessioned2020-10-27T08:18:30Z-
dc.date.available2020-10-27T08:18:30Z-
dc.date.issued2019-11-19
dc.identifier.issn2047-9980
dc.identifier.urihttp://hdl.handle.net/2433/255655-
dc.description.abstractBackground: Prior stroke is regarded as risk factor for bleeding after percutaneous coronary intervention (PCI). However, there is a paucity of data on detailed bleeding risk of patients with prior hemorrhagic and ischemic strokes after PCI. Methods and Results: In a pooled cohort of 19 475 patients from 3 Japanese PCI studies, we assessed the influence of prior hemorrhagic (n=285) or ischemic stroke (n=1773) relative to no-prior stroke (n=17 417) on ischemic and bleeding outcomes after PCI. Cumulative 3-year incidences of the co-primary bleeding end points of intracranial hemorrhage, non-intracranial global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries (GUSTO) moderate/severe bleeding, and the primary ischemic end point of ischemic stroke/myocardial infarction were higher in the prior hemorrhagic and ischemic stroke groups than in the no-prior stroke group (6.8%, 2.5%, and 1.3%, P<0.0001, 8.8%, 8.0%, and 6.0%, P=0.001, and 12.7%, 13.4%, and 7.5%, P<0.0001). After adjusting confounders, the excess risks of both prior hemorrhagic and ischemic strokes relative to no-prior stroke remained significant for intracranial hemorrhage (hazard ratio (HR) 4.44, 95% CI 2.64-7.01, P<0.0001, and HR 1.52, 95% CI 1.06-2.12, P=0.02), but not for non-intracranial bleeding (HR 1.18, 95% CI 0.76-1.73, P=0.44, and HR 0.94, 95% CI 0.78-1.13, P=0.53). The excess risks of both prior hemorrhagic and ischemic strokes relative to no-prior stroke remained significant for ischemic events mainly driven by the higher risk for ischemic stroke (HR 1.46, 95% CI 1.02-2.01, P=0.04, and HR 1.49, 95% CI 1.29-1.72, P<0.0001). Conclusions: Patients with prior hemorrhagic or ischemic stroke as compared with those with no-prior stroke had higher risk for intracranial hemorrhage and ischemic events, but not for non-intracranial bleeding after PCI.
dc.format.mimetypeapplication/pdf
dc.language.isoeng
dc.publisherOvid Technologies (Wolters Kluwer Health)
dc.rightsCopyright © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
dc.subjectstroke
dc.subjectpercutaneous coronary intervention
dc.subjectcoronary artery disease
dc.titleIschemic and Bleeding Risk After Percutaneous Coronary Intervention in Patients With Prior Ischemic and Hemorrhagic Stroke
dc.type.niitypeJournal Article
dc.identifier.jtitleJournal of the American Heart Association
dc.identifier.volume8
dc.identifier.issue22
dc.relation.doi10.1161/JAHA.119.013356
dc.textversionpublisher
dc.identifier.artnume013356
dc.identifier.pmid31701821
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