Outcome of Patients With Prior Stroke/Transient Ischemic Attack and Acute Coronary Syndromes

Zhang, Dongfeng; Song, Xiantao; Chen, Yalei; Raposeiras-Roubín, Sergio; Abu-Assi, Emad; Henriques, Jose Paulo Simao; D'Ascenzo, Fabrizio; Saucedo, Jorge; González-Juanatey, José Ramón; Wilton, Stephen B; Kikkert, Wouter J; Nuñez-Gil, Iván; Ariza-Sole, Albert; Alexopoulos, Dimitrios; Liebetrau, Christoph; Kawaji, Tetsuma; Moretti, Claudio; Huczek, Zenon; Nie, Shaoping; Fujii, Toshiharu

doi:10.1177/0003319719889524

Outcome of Patients With Prior Stroke/Transient Ischemic Attack and Acute Coronary Syndromes

Journal

Angiology

Date Issued

2020-04

Author(s)

Zhang, Dongfeng

Song, Xiantao

Chen, Yalei

Raposeiras-Roubín, Sergio

Abu-Assi, Emad

Henriques, Jose Paulo Simao

D'Ascenzo, Fabrizio

Saucedo, Jorge

González-Juanatey, José Ramón

Wilton, Stephen B

Kikkert, Wouter J

Nuñez-Gil, Iván

Ariza-Sole, Albert

Alexopoulos, Dimitrios

Liebetrau, Christoph

Kawaji, Tetsuma

Moretti, Claudio

Huczek, Zenon

Nie, Shaoping

Fujii, Toshiharu

Correia, Luis

Kawashiri, Masa-Aki

García-Acuña, José María

Southern, Danielle

Alfonso, Emilio

Terol, Belén

Garay, Alberto

Xanthopoulou, Ioanna

Osman, Neriman

Möllmann, Helge

Shiomi, Hiroki

Giordana, Francesca

Kowara, Michal

Filipiak, Krzysztof

Wang, Xiao

Yan, Yan

Fan, Jingyao

Ikari, Yuji

Nakahashi, Takuya

Sakata, Kenji

Yamagishi, Masakazu

DOI

10.1177/0003319719889524

Abstract

The association between prior stroke/transient ischemic attack (TIA) and clinical outcomes in patients with acute coronary syndrome (ACS) has not been well explored. We evaluated the impact of prior stroke/TIA on this specific patient population. We conducted an international multicenter study including 15 401 patients with ACS from the Bleeding Complications in a Multicenter Registry of Patients Discharged With Diagnosis of Acute Coronary Syndrome registry. They were divided into 2 groups: patients with and without prior stroke/TIA. The primary end point was death at 1-year follow-up. Prior stroke/TIA was associated with higher rate of 1-year death (8.7% vs 3.4%; P < .001). It was an independent predictor of 1-year death even after adjustment for confounding variables (odds ratio, 1.705; 95% confidence interval, 1.046-2.778; P = .032). Besides, patients with prior stroke/TIA had significantly increased 1-year reinfarction (5.6% vs 3.8%, P = .015), in-hospital bleeding (8.7% vs 5.8%, P < .001), and 1-year bleeding (5.2% vs 3.0%, P < .001). No difference of antithrombotic therapies or dual antiplatelet therapy (DAPT) types on outcomes was observed in patients with prior stroke/TIA. Prior stroke/TIA was associated with higher 1-year death for patients with ACS who underwent percutaneous coronary intervention. No benefits or harms were observed with different antithrombotic therapies or DAPT types in these patients.