TY - JOUR
T1 - Determinants of stroke following percutaneous coronary intervention in patients with acute coronary syndrome
T2 - a systematic review and meta-analysis
AU - Qanitha, Andriany
AU - Alkatiri, Abdul Hakim
AU - Qalby, Nurul
AU - Soraya, Gita Vita
AU - Alatsari, Muhammad Azka
AU - Larassaphira, Nabilah Puteri
AU - Hanifah, Rif'at
AU - Kabo, Peter
AU - Amir, Muzakkir
N1 - Publisher Copyright:
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2025/12
Y1 - 2025/12
N2 - BACKGROUND: Despite advances in the field, no systematic review has thoroughly documented the occurrence of stroke following Percutaneous Coronary Intervention (PCI) in patients with Acute Coronary Syndrome (ACS). This study aimed to investigate the factors contributing to stroke occurrence post-PCI in ACS patients.METHODS: A systematic search of PubMed and EMBASE identified 2,369 articles. After full-text screening, 109 articles were included in the systematic review, with 55 articles selected for meta-analysis.RESULTS: Data from 18,466,823 patients across 109 studies were analyzed. Among these, 202,999 patients (1.1%) experienced post-PCI stroke. The participants' ages ranged from 49.0 to 87.6 years (mean 64.3 ± 6.2 years). The incidence of early post-PCI stroke within 30 days was 1.1%, while the incidence of stroke occurring >30 days post-PCI was 1.8%, predominantly ischemic strokes. Predictors of stroke following PCI in ACS patients included traditional risk factors (i.e. female sex, older age, diabetes mellitus, hypertension, prior stroke or transient ischemic attack); comorbidities (i.e. chronic kidney disease, atrial fibrillation, anemia, high bleeding risk); and procedural factors (i.e. thrombus aspiration and Clopidogrel use).CONCLUSIONS: This study highlights the relatively low prevalence of stroke following PCI, estimated at approximately 1% of the studied population. These findings emphasize the critical need for continued vigilance in identifying and managing risk factors associated with post-PCI stroke in ACS patients. Future research should prioritize refining risk prediction models, developing innovative preventive strategies, and optimizing post-PCI care pathways to effectively reduce the incidence of stroke in this population.
AB - BACKGROUND: Despite advances in the field, no systematic review has thoroughly documented the occurrence of stroke following Percutaneous Coronary Intervention (PCI) in patients with Acute Coronary Syndrome (ACS). This study aimed to investigate the factors contributing to stroke occurrence post-PCI in ACS patients.METHODS: A systematic search of PubMed and EMBASE identified 2,369 articles. After full-text screening, 109 articles were included in the systematic review, with 55 articles selected for meta-analysis.RESULTS: Data from 18,466,823 patients across 109 studies were analyzed. Among these, 202,999 patients (1.1%) experienced post-PCI stroke. The participants' ages ranged from 49.0 to 87.6 years (mean 64.3 ± 6.2 years). The incidence of early post-PCI stroke within 30 days was 1.1%, while the incidence of stroke occurring >30 days post-PCI was 1.8%, predominantly ischemic strokes. Predictors of stroke following PCI in ACS patients included traditional risk factors (i.e. female sex, older age, diabetes mellitus, hypertension, prior stroke or transient ischemic attack); comorbidities (i.e. chronic kidney disease, atrial fibrillation, anemia, high bleeding risk); and procedural factors (i.e. thrombus aspiration and Clopidogrel use).CONCLUSIONS: This study highlights the relatively low prevalence of stroke following PCI, estimated at approximately 1% of the studied population. These findings emphasize the critical need for continued vigilance in identifying and managing risk factors associated with post-PCI stroke in ACS patients. Future research should prioritize refining risk prediction models, developing innovative preventive strategies, and optimizing post-PCI care pathways to effectively reduce the incidence of stroke in this population.
KW - Acute Coronary Syndrome/surgery
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Comorbidity
KW - Female
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Percutaneous Coronary Intervention/adverse effects
KW - Postoperative Complications/epidemiology
KW - Risk Factors
KW - Stroke/epidemiology
U2 - 10.1080/07853890.2025.2506481
DO - 10.1080/07853890.2025.2506481
M3 - Article
C2 - 40411506
SN - 0785-3890
VL - 57
JO - Annals of Medicine
JF - Annals of Medicine
IS - 1
M1 - 2506481
ER -