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Relation between myocardial infarct location and stroke

M M Bodenheimer1, D Sauer, B Shareef

  • 1Harris Chasanoff Heart Institute, Department of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York 11042.

Journal of the American College of Cardiology
|July 1, 1994
PubMed
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This study found no increased risk of stroke in patients experiencing anterior myocardial infarction compared to nonanterior myocardial infarction. The location of a heart attack does not influence stroke occurrence, challenging previous assumptions about thrombus formation.

Area of Science:

  • Cardiology
  • Neurology
  • Clinical Research

Background:

  • Anterior myocardial infarction is often associated with left ventricular thrombus.
  • This has led to the assumption that thrombi from anterior infarcts cause strokes.
  • This study investigated if anterior infarction increases stroke likelihood.

Purpose of the Study:

  • To compare the incidence of stroke in patients with anterior versus nonanterior myocardial infarction.
  • To determine if the site of myocardial infarction influences stroke risk.
  • To evaluate the presumed causal link between anterior infarction, thrombus, and stroke.

Main Methods:

  • Retrospective analysis of 2,466 patients from a multicenter trial.
  • Patients were randomized post-infarction.

Related Experiment Videos

  • Stroke or transient ischemic attack (TIA) was defined as an event.
  • Main Results:

    • No significant difference in stroke incidence between anterior (3.2%) and nonanterior (3.9%) myocardial infarction.
    • Life table analysis showed no difference in cumulative event rates (p=0.42).
    • Systolic blood pressure was the only significant predictor of stroke; infarction site was not.

    Conclusions:

    • Stroke incidence after acute myocardial infarction is significant.
    • However, stroke occurrence is not related to the infarction site.
    • The presumed causal link between anterior myocardial infarction, thrombus, and stroke is not supported by these data.