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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Published on: January 18, 2018

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Long-Term Risk of Myocardial Infarction Compared to Recurrent Stroke After Transient Ischemic Attack and Ischemic

Marion Boulanger1,2, Yannick Béjot3, Peter M Rothwell2

  • 1Normandie Université UNICAEN, Inserm U1237 CHU Caen, Caen, France.

Journal of the American Heart Association
|January 20, 2018
PubMed

Insights

The risk of myocardial infarction (MI) after ischemic stroke is currently less than 2% annually. Recurrent stroke remains a more frequent cause of death than MI in these patients.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Myocardial infarction (MI) risk post-ischemic stroke or transient ischemic attack (TIA) requires clarification.
  • Understanding long-term risks is crucial for patient management and preventative strategies.

Purpose of the Study:

  • To systematically review and estimate the long-term risk of MI compared to recurrent stroke after ischemic stroke/TIA.
  • To analyze temporal trends in these risks and identify associated risk factors for MI.

Main Methods:

  • Systematic review and random-effect meta-analyses of 58 studies (131,299 patients).
  • Estimation of annual risks and incidence ratios for MI and recurrent stroke (fatal and nonfatal).
  • Poisson regression used to calculate rate ratios for MI based on risk factors.

Main Results:

  • The annual risk of MI was 1.67% and showed a decreasing trend over time.
  • The annual risk of recurrent stroke was 4.26% with no significant temporal change.
  • The risk of fatal MI was half that of fatal recurrent stroke; nonfatal MI risk was 75% lower than nonfatal recurrent stroke.

Conclusions:

  • The current annual risk of MI after ischemic stroke/TIA is below 2%.
  • Recurrent stroke is a more common cause of death than MI in this patient population.
  • Male sex, hypertension, and history of coronary or peripheral artery disease significantly increase MI risk.
Abstract

Keywords:
ischemicmyocardial infarctionstroke

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