Intracranial Hemorrhage in Hospitalized Patients Following Percutaneous Coronary Intervention: A Large Cohort Analysis from a Single Center

• Published in: Diagnostics (Basel) 2023-07, Vol.13 (14), p.2422
• Main Authors: Yang, Cheng, Sui, Yong-Gang, Wang, Bin-Cheng, Xu, Yan-Lu, Wu, Na-Qiong, Wu, Yong-Jian, Li, Jian-Jun, Qian, Jie
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Angina pectoris; Angioplasty; Bivalirudin; Blood pressure; Brain; Cardiac patients; Cardiovascular disease; Care and treatment; clinical characteristics; Clinical outcomes; Clopidogrel; Cohort analysis; coronary artery disease; Coronary heart disease; Coronary vessels; Fatalities; Heart attacks; Hematoma; Hemorrhage; Hospital patients; Hospitalization; Hospitals; incidence; Ischemia; Medical imaging; Mortality; Patients; percutaneous coronary intervention; Statistical analysis; symptomatic intracranial hemorrhage; Transluminal angioplasty; Vein & artery diseases
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics13142422

There are several reports on the prevalence and characteristics of intracranial hemorrhage (ICH) following percutaneous coronary intervention (PCI), which is a rare but severe complication with high mortality. However, the clinical landscapes of computed tomography (CT)-confirmed, symptomatic ICH in hospitalized patients are not fully characterized. Among 121,066 patients receiving PCI treatment in the Fu Wai Hospital between 2013 and 2022, there were 18 CT-defined, symptomatic patients with ICH occurring during post-PCI hospitalization. Symptomatic ICH was defined as clinical suspicion of hemorrhage and/or new focal neurological signs. We analyzed ICH timing, clinical and imaging features, and subsequent outcomes. Overall, in this retrospective analysis, the incidence of CT-defined, symptomatic ICH was 0.015% (18/121,066). More than half of the cases (55.6%) occurred within the first 12 h following PCI. The most common initial manifestation of ICH patients was disturbance of consciousness. Thirteen patients (72.2%) had a hematoma volume ≥ 30 cm . Additionally, the ICH was observed in the cerebral lobe (66.7%), cerebellum (22.2%), and the basal ganglia and thalamus (11.1%). The 90-day mortality of ICH patients undergoing PCI was very high (72.2%). Consciousness disturbance ( = 0.036), intracerebral hemorrhage volume > 30 mm ( = 0.001), and intracerebral hemorrhage originating from the infratentorial origin ( = 0.044) were significantly higher in patients who died. Symptomatic ICH events occur with a rate of around 0.015%, with significantly higher short-term mortality risk in our cohort receiving PCI, which has not yet been demonstrated in other cohorts.