Related Experiment Videos
Importance of cerebrovascular disease in studies of myocardial infarction
L M Brass1, P M Hartigan, W F Page
1Department of Veterans Affairs Medical Center, West Haven, Connecticut, USA.
Insights
Patients with myocardial infarction face a significantly higher risk of stroke. This study highlights the importance of considering stroke alongside heart disease in clinical research and patient care.
Area of Science:
- Cardiovascular Medicine
- Epidemiology
- Atherosclerosis Research
Background:
- Myocardial infarction and stroke share atherosclerosis as a common cause.
- Stroke is often overlooked in studies and trials for ischemic heart disease.
- Assessing stroke's significance in high-risk myocardial infarction patients is crucial.
Purpose of the Study:
- To evaluate the relative importance of stroke in patients at high risk for myocardial infarction.
- To understand the association between myocardial infarction and stroke in a community setting.
- To emphasize stroke as a key outcome in ischemic heart disease research.
Main Methods:
- Analysis of 1985 National Academy of Science Twin Registry data.
- Focus on white male veterans to minimize confounding factors.
- Examination of stroke and myocardial infarction rates in monozygotic twins (individuals and pairs).
Main Results:
- Among 2764 monozygotic twins (58-68 years), myocardial infarction occurred in 10% and stroke in 3.1%.
- Men with a history of myocardial infarction had a 7.5% stroke rate versus 2.4% without (OR=3.3, P<.001).
- A significant association between myocardial infarction and stroke was confirmed in both individual and twin pair analyses.
Conclusions:
- Stroke should be recognized as a significant outcome in myocardial infarction patients.
- Clinical investigations for ischemic heart disease must include stroke as a key endpoint.
- This research underscores the interconnectedness of cardiovascular and cerebrovascular events.
Background And Purpose:
Myocardial infarction and stroke are both predominantly manifestations of atherosclerosis, yet stroke is commonly ignored in prognostic studies and therapeutic trials of ischemic heart disease. Our objective was to assess, in a community setting, the relative importance of stroke among patients at high risk for myocardial infarction.
Methods:
We analyzed 1985 survey data from the National Academy of Science Twin Registry of white male veterans. To minimize confounding by genetic and environmental factors, we restricted our analysis to the rates of stroke and myocardial infarction among monozygotic twins counted as individuals or as twin pairs.
Results:
Among 2764 monozygotic twins aged 58 to 68 years, the overall rate of myocardial infarction was 10% and stroke 3.1%. Among 2632 individual monozygotic twins (95%) with complete responses, the rate of stroke among men with a history of myocardial infarction was 7.5% (17/228) compared with 2.4% (58/2404) among those without myocardial infarction (odds ratio = 3.3, chi square 2 = 19.1, P<.001). A strong association between stroke and myocardial infarction was also found when the data were analyzed for twin pairs (chi square 2 = 135, P<.0005).
Conclusions:
Our results suggest that stroke, in addition to myocardial infarction, should be considered as an outcome in clinical investigations of ischemic heart disease.