Risk of Stroke Associated With Abciximab Among Patients Undergoing Percutaneous Coronary Intervention

Abstract

Abciximab in addition to aspirin and heparin does not increase the risk of stroke in patients undergoing PCI. Patients undergoing PCI and treated with abciximab should receive low-dose, weight-adjusted heparin.

Incidence and Clinical Impact of Stroke Complicating Percutaneous Coronary Intervention

“…The overall rate of periprocedural stroke of 0.4% in an unselected population undergoing PCI is in good accordance with rates reported by other registries during the past 20 years of interventional cardiology. 10,[19][20][21] Some authors previously reported slightly lower 16 (0.22%), others slightly higher rates of stroke during PCI 10 (0.44%). PCI performed under emergency conditions is wellknown to increase the risk for stroke.…”

Periprocedural Stroke and Cardiac Catheterization

“…Although the overall rate of stroke after left heart catheterization or percutaneous coronary intervention (PCI) is low, ranging from 0.2% to 0.4% (Tables 1 and 2), [1][2][3][4][5] it is the most debilitating complication from the patient's perspective, associated with a high rate of morbidity and mortality ( Figure 1). [1][2][3][4][5][6][7][8] In 20 679 consecutive patients who underwent PCI in a large-volume center, stroke occurred in 0.44%.…”

“…[1][2][3][4][5][6][7][8] In 20 679 consecutive patients who underwent PCI in a large-volume center, stroke occurred in 0.44%. 4 Multivariate analysis has shown that the occurrence of stroke was more frequently associated with diabetes mellitus, hypertension, prior stroke, or renal failure and was independently associated with in-hospital death.…”

Stroke Complicating Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

“…27,28 A meta-analysis suggested small excess of ischemic strokes in patients treated with lower doses of abciximab, which might be related to insufficient levels of anti-inflammatory and antiplatelet efficacy. 29 In patients with ACS, vascular inflammation is a systemic condition, which might not be confined to coronary arteries, but extended to carotid arteries. 30 Reducing inflammation and platelet reactivity with those agents might lead to a lower thrombus burden in the vasculature, and a lower probability of thrombus formation on PCI devices, which could decrease the risk of stroke related to the procedure.…”