The risk of stroke after acute myocardial infarction in patients with and without atrial fibrillation: A nationwide cohort study

Chiang, Cheng-Hung; Hung, Wan‐Ting; Huang, Wei-Chun; Jheng, Ying Chun; Wei, Lai; Lin, Yi‐Ying; Lin, Tzu-Wei; Lin, Kung‐Hung; Cheng, Chin-Chang; Kuo, Feng-Yu

doi:10.1097/jcma.0000000000000631

Cited by 4 publications

(2 citation statements)

References 32 publications

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“…In the setting of AMI, AF can manifest either as a pre-existing condition or as a complication. Previous studies indicate an incidence ranging from 2-21% for AF complicating AMI [19, 20]. Consistent with our results, studies also showed that patients with AF following AMI had a significantly higher long-term risk for fatal and non-fatal stroke compared to those without AF regardless of their age, gender or interventional treatment [20, 21].…”

Section: Discussionsupporting

confidence: 91%

Long-term risk of Stroke after Acute Coronary Syndrome. The ABC-10* Study on Heart Disease

Mahmoud,

Cordiano,

Merotto

et al. 2024

Preprint

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BackgroundPrevious studies link myocardial infarction to increased stroke risk. This long-term prospective study examines stroke incidence and outcomes in acute coronary syndrome (ACS) patients, identifying risk factors and geographic disparities.MethodsWe enrolled 535 ACS patients admitted to hospitals across three provinces in the Veneto region of Italy. Patients’ residences were classified into three urban and three rural areas in each province. Patients were followed prospectively for 24 years or until death.ResultsAll patients, except for three, completed the follow-up, totaling 6151 person-years. During follow-up, 84 patients experienced a stroke, with 85% being ischemic and 15% hemorrhagic, proving fatal in 43 cases. The stroke incidence rate was 14/1000 person-years. Multivariable Cox regression analysis identified older age (HR 1.84; 95% CI 1.30-2.60), atrial fibrillation (AF) (HR 2.64; 95% CI 1.49-4.67), and a higher albumin-to-creatinine ratio (HR 1.38; 95% CI 1.04-1.83) as independent predictors of overall stroke risk, while higher eGFR (HR 0.71; 95% CI 0.53-0.95) was independently associated with a lower risk.A sub-analysis revealed older age (HR 2.67; 95% CI 1.60-4.45) and AF (HR 2.95; 95% CI 1.38-6.32) as independent predictors of fatal stroke. Unexpectedly, we observed a higher fatal stroke risk in urban areas (HR 1.89; 95% CI 1.03-3.48) and southern provinces (HR 1.71; 95% CI 1.15-2.53).ConclusionThe ABC study identified several baseline clinical predictors associated with higher stroke risk long after ACS. A geographical association with the risk of fatal stroke was also observed, underscoring the importance of considering both individual clinical predictors and broader geographic factors in stroke prevention policies.

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Section: Discussionsupporting

confidence: 91%

Long-term risk of Stroke after Acute Coronary Syndrome. The ABC-10* Study on Heart Disease

Mahmoud,

Cordiano,

Merotto

et al. 2024

Preprint

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“…This is believed to be a dangerous situation that may lead to death. [5][6][7] Swift detection and medical intervention are vital to restore blood flow and minimize damage. Troponin and creatine kinase are current biomarkers for AMI diagnosis, whereas percutaneous coronary intervention (PCI) is the common approach, alongside drug therapies.…”

Section: Introductionmentioning

confidence: 99%

Recent advances in the diagnosis and management of acute myocardial infarction

Hsieh,

Wang,

Wang

et al. 2023

Journal of the Chinese Medical Association

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With the discovery of new biomarkers for the early detection of acute myocardial infarction (AMI), advancements in valid medication, and percutaneous coronary intervention (PCI), the overall prognosis of AMI has improved remarkably. Nevertheless, challenges remain which require more difficult work to overcome. Novel diagnostic and therapeutic techniques include new AMI biomarkers, hypothermia therapy, supersaturated oxygen (SSO2) therapy, targeted anti-inflammatory therapy, targeted angiogenesis therapy, and stem cell therapy. With these novel methods, we believe that the infarction size after AMI will decrease, and myocardial injury-associated ventricular remodeling may be avoided. This review focuses on novel advances in the diagnosis and management of AMI.

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Preexisting Heart Disease Spectrum and In‐Hospital Outcomes for Patients With Acute Ischemic Stroke

Gu,

Yang,

Zhao

et al. 2024

SVIN

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BACKGROUND Although many studies have examined the influence of individual preexisting heart conditions on stroke outcomes, the combined effects of these conditions remain understudied. METHODS The data supporting this study's findings are available from the corresponding author upon reasonable request. Data on patients with acute ischemic stroke from the Third China National Stroke Registry were analyzed. Preexisting heart disease spectrum was defined based on the combination pattern of coronary heart disease, atrial fibrillation, and heart failure. In‐hospital stroke outcomes included moderate or severe stroke at admission (the National Institutes of Health Stroke Scale score ≥16), ambulation by day 2, and in‐hospital death. RESULTS Among the 14 019 analyzed patients, 1856 (13.2%) had preexisting heart diseases, of which the most common single heart disease was coronary heart disease (1313 [70.7%]), and the most common combination was coronary heart disease and atrial fibrillation (116 [6.3%]). Patients with preexisting heart diseases had higherprevalence of moderate or severe stroke at admission (4.7% versus 1.9%; adjusted odds ratio [aOR], 2.25 [95% CI, 1.73–2.93]), in‐hospital mortality (0.5% versus 0.2%; aOR, 2.41 [95% CI, 1.11–5.25]), and a lower rate of ambulation by day 2 (73.9% versus 78.6%; aOR, 0.84 [95% CI, 0.75–0.95]). Atrial fibrillation alone (moderate or severe stroke: aOR, 4.82 [95% CI, 3.29–7.06]; in‐hospital mortality: aOR, 4.76 [95% CI, 1.58–14.36]; ambulation by day 2: aOR, 0.58 [95% CI, 0.46–0.72]) or in combination with coronary heart disease and heart failure (moderate or severe stroke: aOR, 11.47 [95% CI, 3.66–35.89]; ambulation by day 2: aOR, 0.41 [95% CI, 0.16–1.05]) had the strongest association with unfavorable outcomes. CONCLUSION Preexisting heart diseases, particularly atrial fibrillation combined with other heart diseases, are associated with unfavorable in‐hospital stroke outcomes.

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The risk of stroke after acute myocardial infarction in patients with and without atrial fibrillation: A nationwide cohort study

Cited by 4 publications

References 32 publications

Long-term risk of Stroke after Acute Coronary Syndrome. The ABC-10* Study on Heart Disease

Long-term risk of Stroke after Acute Coronary Syndrome. The ABC-10* Study on Heart Disease

Recent advances in the diagnosis and management of acute myocardial infarction

Preexisting Heart Disease Spectrum and In‐Hospital Outcomes for Patients With Acute Ischemic Stroke

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