Clinical characteristics and mid‐term outcomes of acute myocardial infarction patients with prior cerebrovascular disease in an Asian population: Lessons from the Korea Acute Myocardial Infarction Registry

Abstract

1. The aim of the present study was to evaluated the impact of prior cerebrovascular disease (CVD) on the clinical characteristics and mid-term clinical outcomes of patients with acute myocardial infarction (AMI) in the era of drug-eluting stents. 2. Data from 12 914 patients with acute myocardial infarction who were enrolled in the Korea Acute Myocardial Infarction Registry were analysed retrospectively from November 2005 to December 2007. Prior CVD was defined as having had one or more events of ischaemic or haemorrhagic stroke or a transient ischaemic attack. 3. Of the 12 914 patients reviewed, 906 (7.0%) were found to have had prior CVD. Patients with CVD were older, were more likely to be women and were more likely to have hypertension and diabetes than those without CVD. Patients with prior CVD presented more often with non-ST-segment elevation myocardial infarction and higher Killip class than those without CVD. Furthermore, patients with CVD received less percutaneous coronary intervention (PCI) or thrombolysis compared with those without CVD. Although intensive medical therapy was equal in both groups, clinical outcomes at 8 months showed that patients with CVD had a higher incidence of cardiac death (adjusted odds ratio (OR) 1.42; 95% confidence interval (CI) 1.14-1.76; P = 0.002) and total death (adjusted OR 1.50; 95% CI 1.25-1.81; P < 0.001) than those without CVD. 4. In conclusion, patients with prior CVD presented with worse clinical characteristics on admission and were less likely to receive PCI or thrombolysis than those without CVD. Given the poorer mid-term clinical outcomes, more intensive and aggressive management shouldis recommended for patients with prior CVD to improve their long-term clinical outcome.

Effect of prior stroke on long‐term outcomes of percutaneous coronary interventions in Chinese patients: A large single‐center study

“…Most previous studies of patients with prior stroke undergoing PCI have focused on patients with acute MI, or only discussed the in‐hospital and short‐term prognosis . In the current study, all patients undergoing PCI, including those with ACS and stable CHD, were consecutively enrolled, which reflects the situation in the real world.…”

‘Smoker's paradox’ in young patients with acute myocardial infarction

“…The design of the KAMIR study has been previously described. 15,16 Briefly, it is a Korean prospective multicentre online registry designed to reflect the 'real world' practice in Korean AMI patients in the drug-eluting stents (DES) era that was established with support from the Korean Circulation Society in November 2005. Forty-one major cardiovascular centres have registered details of AMI patients via the website (http://www.kamir.or.kr, accessed 31 August 2008).…”

Time Trend and Age-Period-Cohort Effects on Acute Myocardial Infarction Mortality in Korean Adults from 1988 to 2007

“…A nationwide multicenter registry of AMI in Korea, the Korea Acute Myocardial Infarction Registry, was established in November 2005, and studies that have evaluated clinical characteristics and treatment outcomes of AMI patients in Korea have been reported (4, 5). Hong et al (6) analyzed data from the Korean National Health Insurance Database and reported time trends in the incidence of AMI in Korea from 1997 to 2007.…”