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Factors associated with development of stroke long-term after myocardial infarction: experiences from the LoWASA

J Herlitz1, J Holm, M Peterson

  • 1Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. johan.herlitz@hik.gu.se

Journal of Internal Medicine
|January 20, 2005
PubMed

Insights

Long-term stroke risk after acute myocardial infarction (AMI) is increased by age, diabetes, prior stroke, hypertension, and smoking. These factors predict non-hemorrhagic stroke development.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Clinical Research

Background:

  • Acute myocardial infarction (AMI) survivors face long-term risks, including stroke.
  • Identifying stroke predictors post-AMI is crucial for preventative strategies.

Purpose of the Study:

  • To identify factors associated with stroke development during long-term follow-up after acute myocardial infarction (AMI).
  • To analyze stroke risk indicators in patients treated post-AMI within the LoWASA trial.

Main Methods:

  • Patients hospitalized for AMI were randomized to warfarin plus aspirin or aspirin alone.
  • The LoWASA trial involved 3300 patients across 31 Swedish hospitals with a mean follow-up of 5.0 years.
  • An open-label treatment with blinded endpoint evaluation design was employed.

Main Results:

  • 194 patients (5.9%) experienced stroke, predominantly non-hemorrhagic.
  • Independent predictors for increased stroke risk included advanced age, history of diabetes mellitus, prior stroke, hypertension, and smoking.
  • These factors were primarily associated with non-hemorrhagic stroke; no specific predictors for hemorrhagic stroke were identified.

Conclusions:

  • Increasing age and a history of diabetes mellitus, stroke, hypertension, or smoking are significant risk indicators for stroke long-term after AMI.
  • These findings highlight key modifiable and non-modifiable risk factors for targeted interventions in post-AMI patients.
Abstract

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