Long-term mortality after stroke is higher than after myocardial infarction

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Coronary heart disease and ischemic stroke (IS) mortality rates in Poland are among Europe's highest.
• Despite shared risk factors, acute myocardial infarction (AMI) and IS have different patient demographics and acute treatment, complicating prognosis comparisons.

Purpose of the Study:

• To investigate if long-term prognosis is worse for patients who have had an ischemic stroke (IS) compared to those who have had an acute myocardial infarction (AMI).
• To analyze long-term mortality (LTM) differences between post-IS and post-AMI patients, considering age and sex.

Main Methods:

• A study in Gdynia, Poland, involving 997 patients (464 post-IS, 533 post-AMI) surviving hospitalization between 2000-2005.
• Long-term mortality (LTM) was assessed using standardized mortality ratios, Kaplan-Meier survival curves, and Cox proportional hazard regression over a 1 to 11-year observation period.

Main Results:

• Overall mortality was lower in the post-AMI group (38.8%) compared to the post-IS group (51.5%).
• This survival difference was more pronounced in males, with significantly higher LTM in post-IS males (57.8%) versus post-AMI males (39.7%).
• Cox regression confirmed that IS diagnosis increased long-term mortality risk in males.

Conclusions:

• Long-term prognosis is significantly worse for patients following an ischemic stroke (IS) compared to those recovering from acute myocardial infarction (AMI).
• Male patients experiencing an ischemic stroke face a particularly poorer long-term survival outlook than male patients with acute myocardial infarction.