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

Mortality caused by coronary heart disease and ischemic stroke (IS) in Poland is still among the highest in Europe. Because acute myocardial infarction (AMI) and IS share major common risk factors, it would be expected that trends in long-term mortality (LTM) and incidence of these two diseases would be similar. Nevertheless, better AMI acute phase therapy and older age of IS patients make post-IS and post-AMI prognosis difficult to compare. The aim of the study was to verify the thesis that, regardless of age and sex, the long-term prognosis is worse for post-IS than for post-AMI subjects. The study was conducted in Polish city-Gdynia (250,000 of inhabitants) among 997 subjects (464 post-IS, 533 post-AMI) randomly selected from all post-IS and post-AMI patients, witch survived hospitalization period in years 2000-2005. The observation period varied from 1 month to 11 years. LTM was shown as standardized mortality ratios. Kaplan-Meyer survival curves and Cox proportional hazard regression model were used to compare LTM in post-IS and post-AMI subjects. Post-IS and post-AMI groups did not differ by sex or age of event. Fewer deaths were recorded in post-AMI group (38.8 vs. 51.5 %, OR 0.60, 95 % CI 0.46-0.77). This difference was most evident in males (39.7 vs. 57.8 %, OR 0.48, 95 % CI 0.34-0.66). Kaplan-Meyer estimates showed faster reduction of survival probability in the post-IS males. In Cox regression model presence of IS increased long-term mortality in males. Long-term prognosis was worse for post-IS males in comparison with post-AMI population from Gdynia.