Stroke after acute myocardial infarction: relation to infarct size.

Abstract

Summary and conclusionsIn a consecutive series of 783 patients with acute myocardial infarction, 13 (17%) suffered a stroke. In all but one case the strokes occurred among the 255 patients whose peak creatine kinase (CK) concentrations fell in the upper third of the range of values (over 1160 IU/l, about eight times the upper limit of normal); the exception was a patient with a pre-existing ventricular aneurysm. The incidence of stroke in the patients with CK over 1160 IU/l was 4-7%, 24 times the incidence when peak CK was below this value (0-2%). Higher peak serum enzyme concentrations were associated with an even higher incidence of stroke. Comparison of peak enzyme concentrations with cumulated CK showed a close correlation (r =0 90 with peak CK; r=0-85 with peak aspartate transaminase), suggesting that the peak enzyme values reflected infarct size.Thus the risk of stroke after infarction was a function of the size of the myocardial infarct; two-thirds of the patients had negligible risk of stroke and did not need anticoagulant prophylaxis.

Factors associated with development of stroke long‐term after myocardial infarction: experiences from the LoWASA trial

“…Another factor associated with an increased risk of stroke is infarct size [7,11]. This was not evaluated in this survey.…”

Stroke Complicating Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

“…11,12 Previous studies have shown that anterior wall STEMI has higher risk of inhospital stroke. 14,19,20 Patients with anterior wall STEMI are more likely to have low ejection fraction, 21 and the incidence of left ventricular mural thrombus is higher, 22 which might account for the higher risk of stroke in those populations. The results of our study are generally in line with those previous reports, except for the absence of upstream use of GP IIb/IIIa inhibitors as a risk factor.…”

Accidente cerebrovascular isquémico en pacientes con trombo intracavitario: Experiencia con tratamientos distintos en fase aguda

“…Los factores de riesgo más relacionados entre ambos eventos son edad avanzada, clase funcional de Killip, extensión del infarto y ubicación en pared anterior [6][7][8] . Destacamos un estudio de 20.768 pacientes hospitalizados por IAM, donde la incidencia de ACV isquémicos o hemorrágicos entre pacientes que recibieron heparina profiláctica y quienes no, no mostró diferencias significativas 6 .…”