Abstract P426: Platelet Glycoprotein IIb/IIIa Inhibitors as an Adjunct to Stent Placement of Carotid Stenosis in Symptomatic Patients

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Sachin M Bhagavan ◽  
Ammad Ishfaq ◽  
Muhammad F Ishfaq ◽  
Mukaish Kumar ◽  
Shruthi Pulimamidi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Carotid Stenosis ◽  
Transient Ischemic Attack ◽  
Stent Placement ◽  
Severe Disability ◽  
Platelet Glycoprotein ◽  
Carotid Stent ◽  
Significant Difference ◽  
Ischemic Attack

Background: Intra-arterial or intravenous platelet glycoprotein (GP) IIb/IIIa inhibitors have been used as adjunct to stent placement of carotid stenosis in patients with ischemic stroke or transient ischemic attack. Objective: To determine the proportion of patients with ischemic stroke or transient ischemic attack who received platelet GP IIb/IIIa inhibitors as adjunct to carotid stent placement and associated outcomes. Methods: We analyzed data from Cerner Health Facts® which collected data from participating facilities from January 1, 2000 to July 1, 2018. We identified patients with ischemic stroke or transient ischemic attack who underwent carotid stent placement for carotid stenosis and received Abciximab, Eptifibatide, or Tirofiban. Outcome was defined by discharge destination and classified into none to minimal disability, moderate to severe disability, or death. Results: A total of 8.4 % of 4567 patients with ischemic stroke or transient ischemic attack who underwent carotid stent placement for carotid stenosis received platelet GP IIb/IIIa inhibitors. Patients who received platelet GP IIb/IIIa inhibitors were more likely to experience cerebral ischemia (14.8% versus 7.5%) and undergo intubation/mechanical ventilation (4.4% versus 2%). There was a significant difference between patients who did or did not receive platelet GP IIb/IIIa inhibitors in terms of in hospital mortality rates (2.7% versus 1.2%, p=0.0152), none to mild disability (67.3% vs 75.7%, p=0.0003), and moderate to severe disability (30.1% vs 23.1%,p=0.0024). Conclusions: Adjunct use of platelet GP IIb/IIIa inhibitors in patients undergoing carotid stent placement for symptomatic carotid stenosis was associated with increased rates of in hospital mortality and moderate to severe disability.

scholarly journals Stroke Epidemiology, Patterns of Management, and Outcomes in Fortaleza, Brazil

Stroke ◽  
2011 ◽  
Vol 42 (12) ◽  
pp. 3341-3346 ◽  
Author(s):  
João José Freitas de Carvalho ◽  
Monique Bueno Alves ◽  
Georgiana Álvares Andrade Viana ◽  
Cícera Borges Machado ◽  
Bento Fortunato Cardoso dos Santos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Hospital Admission ◽  
Median Time ◽  
Transient Ischemic Attack ◽  
Stroke Risk Factors ◽  
Level Of Consciousness ◽  
Ischemic Attack ◽  
Stroke Epidemiology

Background and Purpose— Little information exists on the epidemiology and patterns of treatment of patients admitted to Brazilian hospitals with stroke. Our objective was to describe the frequency of risk factors, patterns of management, and outcome of patients admitted with stroke in Fortaleza, the fifth largest city in Brazil. Methods— Data were prospectively collected from consecutive patients admitted to 19 hospitals in Fortaleza with a diagnosis of stroke or transient ischemic attack from June 2009 to October 2010. Results— We evaluated 2407 consecutive patients (mean age, 67.7±14.4 years; 51.8% females). Ischemic stroke was the most frequent subtype (72.9%) followed by intraparenchymal hemorrhage (15.2%), subarachnoid hemorrhage (6.0%), transient ischemic attack (3%), and undetermined stroke (2.9%). The median time from symptoms onset to hospital admission was 12.9 (3.8–32.5) hours. Hypertension was the most common risk factor. Only 1.1% of the patients with ischemic stroke received thrombolysis. The median time from hospital admission to neuroimaging was 3.4 (1.2–26.5) hours. In-hospital mortality was 20.9% and the frequency of modified Rankin Scale score ≤2 at discharge was less than 30%. Older age, prestroke disability, and having a depressed level of consciousness at admission were independent predictors of poor outcome; conversely, male gender was a predictor of good outcome. Conclusions— The prevalence of stroke risk factors and clinical presentation in our cohort were similar to previous series. Treatment with thrombolysis and functional independency after a stroke admission were infrequent. We also found long delays in hospital admission and in evaluation with neuroimaging and high in-hospital mortality.

scholarly journals Carotid Stenosis and Recurrent Ischemic Stroke

Stroke ◽  
2021 ◽  
Author(s):  
Shadi Yaghi ◽  
Adam de Havenon ◽  
Sara Rostanski ◽  
Alexandra Kvernland ◽  
Brian Mac Grory ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
High Risk ◽  
Carotid Stenosis ◽  
Transient Ischemic Attack ◽  
Stroke Risk ◽  
Hazard Ratio ◽  
Minor Ischemic Stroke ◽  
Increased Risk ◽  
Ischemic Stroke Risk ◽  
Ischemic Attack

Background and Purpose: Randomized trials demonstrated the benefit of dual antiplatelet therapy in patients with minor ischemic stroke or high-risk transient ischemic attack. We sought to determine whether the presence of carotid stenosis was associated with increased risk of ischemic stroke and whether the addition of clopidogrel to aspirin was associated with more benefit in patients with versus without carotid stenosis. Methods: This is a post-hoc analysis of the POINT trial (Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke) that randomized patients with minor ischemic stroke or high-risk transient ischemic attack within 12 hours from last known normal to receive either clopidogrel plus aspirin or aspirin alone. The primary predictor was the presence of ≥50% stenosis in either cervical internal carotid artery. The primary outcome was ischemic stroke. We built Cox regression models to determine the association between carotid stenosis and ischemic stroke and whether the effect of clopidogrel was modified by ≥50% carotid stenosis. Results: Among 4881 patients enrolled POINT, 3941 patients met the inclusion criteria. In adjusted models, ≥50% carotid stenosis was associated with ischemic stroke risk (hazard ratio, 2.45 [95% CI, 1.68–3.57], P <0.001). The effect of clopidogrel (versus placebo) on ischemic stroke risk was not significantly different in patients with <50% carotid stenosis (adjusted hazard ratio, 0.68 [95% CI, 0.50–0.93], P =0.014) versus those with ≥50% carotid stenosis (adjusted hazard ratio, 0.88 [95% CI, 0.45–1.72], P =0.703), P value for interaction=0.573. Conclusions: The presence of carotid stenosis was associated with increased risk of ischemic stroke during follow-up. The effect of added clopidogrel was not significantly different in patients with versus without carotid stenosis. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03354429.

Risk factor control after ischemic stroke or transient ischemic attack

2021 ◽  
Author(s):  
Nanxiang Ouyang ◽  
Chuning Shi ◽  
Xiaofan Guo ◽  
Yihan Chen ◽  
Yingxian Sun
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Risk Factor Control ◽  
Ischemic Attack

PATIENTS WITH ISCHEMIC STROKE HAVE A HIGHER PREVALENCE OF ABNORMAL PLANAR QRS-T ANGLE THAN PATIENTS WITH TRANSIENT ISCHEMIC ATTACK

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 102S
Author(s):  
Kaushang Gandhi ◽  
Wilbert S. Aronow ◽  
Chandrasekar Palaniswamy ◽  
Harshad Amin ◽  
Harit Desai ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Ischemic Attack
Sign in / Sign up

Export Citation Format

Share Document