Outcome of Patients With Prior Stroke/Transient Ischemic Attack and Acute Coronary Syndromes

Area of Science:

• Cardiology
• Neurology
• Clinical Research

Background:

• The impact of prior stroke/transient ischemic attack (TIA) on acute coronary syndrome (ACS) patient outcomes remains under-investigated.
• Understanding these associations is crucial for optimizing patient care and risk stratification.

Purpose of the Study:

• To evaluate the clinical outcomes in patients with ACS who have a history of stroke or TIA.
• To determine if prior stroke/TIA is an independent predictor of mortality and other adverse events in ACS patients.

Main Methods:

• An international multicenter registry study included 15,401 ACS patients.
• Patients were categorized into those with and without prior stroke/TIA.
• Primary endpoint was 1-year mortality, with secondary endpoints including reinfarction and bleeding events.

Main Results:

• Prior stroke/TIA was linked to a significantly higher rate of 1-year death (8.7% vs 3.4%, P < .001).
• It independently predicted 1-year mortality (OR, 1.705; P = .032) and was associated with increased reinfarction and bleeding events.
• No significant differences in outcomes were found based on antithrombotic or dual antiplatelet therapy (DAPT) types in patients with prior stroke/TIA.

Conclusions:

• Prior stroke/TIA is a significant independent predictor of adverse outcomes, including death, reinfarction, and bleeding, in patients with ACS.
• These findings highlight the need for careful management and risk assessment in ACS patients with a history of stroke/TIA.
• Current antithrombotic and DAPT strategies did not show differential benefits or harms in this high-risk subgroup.