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Impact of Previous Stroke on Short-Term Myocardial Reinfarction in Patients With Acute ST Segment Elevation

Li Tian1, Yanmin Yang, Jun Zhu

  • 1From the Department of cardiology, The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education (LT, BY); State Key Laboratory of Cardiovascular Disease, Emergency and Critical Care Centre of Cardiovascular Department, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (YY, JZ, LL, YL, JL).

Medicine
|February 13, 2016
PubMed

Insights

Short-term myocardial reinfarction is common after ST-elevation myocardial infarction (STEMI). Previous stroke significantly increases this risk, while statin use can reduce it, highlighting key factors for STEMI patient care.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Myocardial reinfarction is a frequent complication following ST-elevation myocardial infarction (STEMI).
  • A significant proportion of STEMI patients have a history of previous stroke, a known cardiovascular risk factor.

Purpose of the Study:

  • To evaluate risk factors for short-term myocardial reinfarction in STEMI patients.
  • To investigate the association between previous stroke and short-term reinfarction rates.
  • To assess the impact of statin use on reinfarction risk in STEMI patients.

Main Methods:

  • A multicenter study enrolled 6876 STEMI patients in China with chest pain onset within 12 hours.
  • Patients underwent 7- and 30-day follow-ups.
  • Kaplan-Meier survival analysis and multivariable Cox regression were used to identify independent predictors of 30-day myocardial reinfarction.

Main Results:

  • The overall 30-day myocardial reinfarction rate was 2.0%.
  • STEMI patients with a history of previous stroke had a significantly higher 30-day reinfarction rate (4.2%) compared to those without (P < 0.001).
  • Previous stroke (HR, 3.673) and statin use (HR, 0.230) were identified as independent predictors for 30-day myocardial reinfarction.

Conclusions:

  • A substantial number of STEMI patients have a history of stroke, posing a higher risk for short-term reinfarction.
  • Previous stroke is a significant independent risk factor for short-term myocardial reinfarction post-STEMI.
  • Statin therapy demonstrates a protective effect, reducing the risk of short-term myocardial reinfarction in STEMI patients.

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