Related Experiment Videos
The association of stroke and coronary heart disease: a population study
D D Dexter1, J P Whisnant, D C Connolly
1Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Insights
Individuals diagnosed with myocardial infarction face an increased stroke risk within two months, particularly those with transmural myocardial infarction. Angina pectoris patients showed no elevated stroke risk, while cerebral infarction patients had a delayed risk of heart attack or sudden death.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Epidemiology
Background:
- Cardiovascular diseases, including angina pectoris, myocardial infarction, and cerebral infarction, represent significant public health concerns.
- Understanding the long-term risks of subsequent cardiovascular or cerebrovascular events is crucial for patient management and preventative strategies.
Purpose of the Study:
- To estimate the cumulative probability of stroke following angina pectoris.
- To assess the risk of stroke after myocardial infarction.
- To determine the likelihood of myocardial infarction or sudden death after cerebral infarction.
Main Methods:
- A 20-year population-based cohort study (1960-1979) was conducted.
- Cumulative probabilities of specific events were estimated and compared to expected values.
- Analyses were stratified by initial diagnosis (angina, myocardial infarction, cerebral infarction) and infarction type (transmural vs. subendocardial).
Main Results:
- No significant difference in stroke probability was observed in angina pectoris patients up to 10 years post-diagnosis.
- A significant excess stroke probability was noted at 1 and 2 months post-myocardial infarction, especially in transmural cases.
- The risk of myocardial infarction or sudden death after cerebral infarction became significant at 5 years and remained stable thereafter.
Conclusions:
- Myocardial infarction, particularly transmural, confers an early, significant risk of subsequent stroke.
- Angina pectoris does not appear to increase stroke risk in the long term.
- Cerebral infarction patients face a delayed but significant risk of major adverse cardiac events.
Abstract:
In a 20-year population-based study (1960 through 1979), we estimated the cumulative probability of (1) the occurrence of stroke after a diagnosis of angina pectoris, (2) the occurrence of stroke after a diagnosis of myocardial infarction, and (3) the occurrence of myocardial infarction or sudden unexpected death after a diagnosis of cerebral infarction. In patients in whom angina had been diagnosed, no significant difference was noted between the observed and the expected probability of stroke throughout 10 years of follow-up. In patients with a diagnosis of myocardial infarction, a significant difference was noted between observed and expected probabilities of stroke at 1 month and at 2 months. This early excess in probability of stroke was especially pronounced in the subgroup of patients with transmural myocardial infarction but not evident in those with subendocardial myocardial infarction. Among patients with a diagnosis of cerebral infarction, the difference between observed and expected probabilities of myocardial infarction or sudden unexpected death was not significant until 5 years after the cerebral infarction and showed no change thereafter.