ABSTRACT NUMBER: ESOC2026A388 IN-HOSPITAL STROKE IN PATIENTS WITH CARDIAC CONDITIONS: DO CARDIAC PROCEDURES IMPACT STROKE OUTCOMES?

Abstract Background and aims It is unclear if stroke after cardiac procedures is more severe than stroke associated with other cardiac conditions. We compared in-hospital acute ischemic stroke (AIS) patients primarily admitted with a cardiac diagnosis who did versus did not undergo invasive cardiac procedures. Methods In a retrospective cohort study, we analyzed adults with in-hospital AIS primarily admitted with a cardiac diagnosis in Alberta (2018-2022). We compared clinical characteristics and outcomes between patients who did versus did not undergo invasive cardiac procedures <30 days before AIS. We estimated associations between having undergone procedures and outcomes using multivariable logistic regression. Results Among 499 patients admitted for a cardiac diagnosis (median age 70 years IQR 62-77, 36.7% women), 343 (68.7%) underwent any cardiac procedure prior to their in-hospital stroke. Coronary bypass grafting (92/343 26.8%) was the most common procedure. Median time from procedure to stroke diagnosis was 1.75 days (IQR 0.87–3.83). In-hospital mortality was nominally lower in the procedure group (79/343 [23.0%] vs 54/156 [34.6%], p-value 0.007) but not after adjustment for age, sex and facility level (aOR 0.70, 95% CI 0.41-1.17). ICU admission was higher in the procedure group (62.7% vs 31.4%, p<0.001), while medical complication rates were similar. In the procedure group, strokes >2 days post-procedure were associated with higher mortality (2-7 days: OR 2.24, [1.17–4.30]; 8-30 days: OR 3.23, [1.59–6.58]); age, sex, procedure type, and acute treatment were not. Conclusions Delayed procedure-related strokes are associated with higher mortality, emphasizing vigilance in hospitalized cardiac patients. Conflict of interest Ameen Alizada: nothing to disclose. Rana Abdalrahman: nothing to disclose. Dana Harris: nothing to disclose. Jillian Stang: nothing to disclose. Benjamin Agnelli: nothing to disclose. Jessalyn Holodinsky: nothing to disclose. Bijoy Menon: nothing to disclose. Michael Hill: nothing to disclose. Mohammed Almekhlafi: nothing to disclose. Katrina Hannah Ignacio: nothing to disclose.