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Acute Myocardial Infarction in Rats
Published on: February 16, 2011
Myocardial infarction after acute ischaemic stroke: Incidence, mortality and risk factors
Tiberiu A Pana1, Adrian D Wood1, Mamas A Mamas2
1Ageing Clinical and Experimental Research Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK.
Insights
This study identified risk factors for myocardial infarction (MI) after acute ischaemic stroke (AIS). Identifying these factors can help focus preventative efforts and improve outcomes for stroke survivors at risk of heart attack.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Epidemiology
Background:
- Acute ischaemic stroke (AIS) survivors face an increased risk of myocardial infarction (MI).
- Understanding the risk factor profiles associated with post-stroke MI is crucial for long-term patient management.
Purpose of the Study:
- To determine the risk factor profiles associated with myocardial infarction (MI) following acute ischaemic stroke (AIS).
- To examine the long-term incidence of MI and its impact on mortality in AIS patients.
Main Methods:
- An observational study of 9840 prospectively identified AIS patients admitted to a UK center (2003-2016).
- Logistic and Cox regression models were used to identify predictors of in-hospital and post-discharge MI.
- MI incidence and the influence of post-stroke MI on mortality were analyzed using competing risk and Cox regression models.
Main Results:
- In-hospital MI was associated with elevated blood glucose, total leucocyte count, and C-reactive protein (CRP).
- Between discharge and 10 years post-stroke, incident MI was linked to age, coronary heart disease, chronic kidney disease, cancers, diabetes, congestive heart failure, hypertension, and peripheral vascular disease.
- Cumulative MI incidence over 10 years was 5.4%, and MI during follow-up significantly increased the risk of death.
Conclusions:
- Prognosis for patients experiencing myocardial infarction after acute ischaemic stroke is poor.
- Identifying specific risk factor profiles can guide targeted preventative strategies to mitigate MI risk and improve survival in AIS patients.
Objectives:
To determine the risk factor profiles associated with post-acute ischaemic stroke (AIS) myocardial infarction (MI) over long-term follow-up.
Methods:
This observational study includes prospectively identified AIS patients (n = 9840) admitted to a UK regional centre between January 2003 and December 2016 (median follow-up: 4.72 years). Predictors of post-stroke MI during follow-up were examined using logistic and Cox regression models for in-hospital and post-discharge events, respectively. MI incidence was determined using a competing risk non-parametric estimator. The influence of post-stroke MI on mortality was examined using Cox regressions.
Results:
Mean age (SD) of study participants was 77.3 (12.2) years (48% males). Factors associated with in-hospital MI (OR [95% CI]) were increasing blood glucose (1.80 [1.17-2.77] per 10 mmol/L), total leucocyte count (1.25 [1.01-1.54] per 10 × 109 /L) and CRP (1.05 [1.02-1.08] per 10 mg/L increase). Age (HR [95% CI] = 1.03 [1.01-1.06]), coronary heart disease (1.59 [1.01-2.50]), chronic kidney disease (2.58 [1.44-4.63]) and cancers (1.76 [1.08-2.89]) were associated with incident MI between discharge and one-year follow-up. Age (1.02 [1.00-1.03]), diabetes (1.96 [1.38-2.65]), congestive heart failure (2.07 [1.44-2.99]), coronary heart disease (1.81 [1.31-2.50]), hypertension [1.86 (1.24-2.79)] and peripheral vascular disease (2.25 [1.40-3.63]) were associated with incident MI between 1 and 5 years after discharge. Diabetes (2.01 [1.09-3.72]), hypertension (3.69 [1.44-9.45]) and peripheral vascular disease (2.46 [1.02-5.98]) were associated with incident MI between 5 and 10 years after discharge. Cumulative MI incidence over 10 years was 5.4%. MI during all follow-up periods (discharge-1, 1-5, 5-10 years) was associated with increased risk of death (respective HR [95% CI] = 3.26 [2.51-4.15], 1.96 [1.58-2.42] and 1.92 [1.26-2.93]).
Conclusions:
In conclusion, prognosis is poor in post-stroke MI. We highlight a range of potential areas to focus preventative efforts.
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