Twenty-Year Trends in the Incidence of Stroke Complicating Acute Myocardial Infarction

Abstract

Given the improved survival of patients hospitalized with acute myocardial infarction (AMI) during the past several decades,¹ an increasing pool of patients are at risk for serious complications of AMI, including ischemic and hemorrhagic stroke. Although stroke is a relatively infrequent complication of AMI, with approximately 1% to 2% of patients with AMI developing a stroke during their index hospitalization,² the occurrence of stroke in patients with AMI is associated with increased morbidity and mortality.^3,4 In addition, clinical and epidemiologic studies^5,6 reported an excess risk of stroke after myocardial infarction (MI) during the 1980s and 1990s, trends coincident with the increasing use of thrombolytic therapy for the hospital management of patients with AMI. The risk of in-hospital stroke complicating AMI has not been well characterized; however, particularly during recent periods, neither has the potentially changing association between the occurrence of stroke and hospital death rates.