Coronary artery disease, myocardial infarction, and brain embolism

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2-Vessel Occlusion/Hypotension: A Rat Model of Global Brain Ischemia
09:29

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Published on: June 22, 2013

D C Hess1, I A D'Cruz, R J Adams

  • 1Neurology Service, Veterans Affairs Medical Center, Augusta, Georgia.

Neurologic Clinics
|May 1, 1993
PubMed

Insights

In-hospital stroke complicates about 1% of acute myocardial infarctions, with risk factors including large infarcts and prior stroke. Certain thrombolytic therapies increase stroke risk due to cerebral hemorrhages.

Area of Science:

  • Cardiology
  • Neurology
  • Thrombolytic Therapy

Background:

  • In-hospital stroke occurs in approximately 1% of acute myocardial infarction (AMI) cases.
  • Risk factors for stroke include large infarcts, anterior wall involvement, prior stroke history, and advanced age.
  • Left ventricular thrombi, often associated with anterior wall AMI, may be reduced by anticoagulation.

Purpose of the Study:

  • To review the incidence and risk factors of in-hospital stroke following AMI.
  • To evaluate the impact of thrombolytic therapies on stroke risk.
  • To discuss the role of anticoagulation in managing left ventricular thrombi and preventing embolization.

Main Methods:

  • Literature review of studies on stroke complicating AMI.
  • Analysis of risk factors for ischemic stroke in AMI patients.
  • Comparison of stroke rates associated with different thrombolytic agents.

Main Results:

  • The overall incidence of stroke post-AMI is around 1%, largely unaffected by thrombolytic therapy.
  • Specific thrombolytic agents like t-PA and APSAC increase stroke risk due to cerebral hemorrhages compared to streptokinase.
  • Left ventricular aneurysms have a low embolization risk and do not necessitate anticoagulation.

Conclusions:

  • Stroke in AMI patients is influenced by factors such as infarct size, location, and patient history.
  • The choice of thrombolytic therapy can significantly impact the risk of hemorrhagic stroke.
  • Anticoagulation may be beneficial for left ventricular thrombi but is not indicated for left ventricular aneurysms.

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