{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:21:37Z","timestamp":1765887697488,"version":"3.41.2"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Patients with ST-segment\u2013elevation myocardial infarction are at increased risk of cerebrovascular events. We assessed the incidence, predictors, and implications of cerebrovascular events in patients with ST-segment\u2013elevation myocardial infarction managed with a primary percutaneous coronary intervention strategy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              In the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, 72 of 3602 patients (2.0%) experienced at least 1 cerebrovascular event (stroke: 63 patients; transient ischemic attack: 12 patients) during the 3-year follow-up (40.3% within 30 days, 20.8% between 30 days and 1 year, and 38.9% between 1 and 3 years). Stroke was ischemic in 58 (92.1%) patients and hemorrhagic in 5 (7.9%) patients. More than half of all strokes (52.3%) were disabling. By principal management strategy, cerebrovascular events developed in 2.0%, 14.9%, and 1.9% of patients triaged to primary percutaneous coronary intervention, coronary artery bypass grafting, and medical therapy, respectively (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). Cerebrovascular events were independently predicted by older age, creatinine clearance &lt;60 mL\/min, treatment with coronary artery bypass grafting, anemia, and diabetes mellitus. Cerebrovascular events were associated with significantly increased rates of 3-year mortality (20.5% versus 6.5%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), as well as reinfarction (14.3% versus 3.8%;\n              <jats:italic>P<\/jats:italic>\n              =0.0007), ischemia-driven target vessel revascularization (22.8% versus 13.0%;\n              <jats:italic>P<\/jats:italic>\n              =0.006), and major bleeding (23.5% versus 8.4%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In HORIZONS-AMI, cerebrovascular events within 3 years after ST-segment\u2013elevation myocardial infarction in patients undergoing a primary percutaneous coronary intervention management strategy occurred in 2.0% of patients and were most frequent after coronary artery bypass grafting. Cerebrovascular events were often disabling and were strongly associated with high rates of death, reinfarction, recurrent ischemia, and major bleeding.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00433966.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.114.002283","type":"journal-article","created":{"date-parts":[[2015,4,10]],"date-time":"2015-04-10T02:31:50Z","timestamp":1428633110000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Cerebrovascular Events After a Primary Percutaneous Coronary Intervention Strategy for Acute ST-Segment\u2013 Elevation Myocardial Infarction"],"prefix":"10.1161","volume":"8","author":[{"given":"Eugenia","family":"Nikolsky","sequence":"first","affiliation":[{"name":"From the Cardiology Department, Rambam Health Care Campus and the Technion\u2013Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Qu\u00e9bec, Canada (P.G..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxana","family":"Mehran","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, Rambam Health Care Campus and the Technion\u2013Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Qu\u00e9bec, Canada (P.G..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George D.","family":"Dangas","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, Rambam Health Care Campus and the Technion\u2013Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Qu\u00e9bec, Canada (P.G..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Xu","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, Rambam Health Care Campus and the Technion\u2013Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Qu\u00e9bec, Canada (P.G..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupa","family":"Parvataneni","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, Rambam Health Care Campus and the Technion\u2013Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Qu\u00e9bec, Canada (P.G..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard","family":"Witzenbichler","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, Rambam Health Care Campus and the Technion\u2013Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); 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