Incidence and Outcomes of Myocardial Infarction in Patients Admitted With Acute Ischemic Stroke
- 1 November 2017
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 48 (11), 2931-2938
- https://doi.org/10.1161/strokeaha.117.018408
Abstract
Background and Purpose— Data on the incidence and outcomes of acute myocardial infarction (AMI) complicating acute ischemic stroke (AIS) are limited. We aim to evaluate the incidence, treatment patterns, and outcomes of AMI in patients with AIS using a nationwide database. Methods— The National Inpatient Sample was used to identify patient with AIS between 2003 and 2014. Trends of incidence of AMI and its associated in-hospital mortality were evaluated. Univariate and multivariate logistic regressions were used to evaluate predictors of AMI. The impact of AMI on in-hospital outcomes was assessed in a comparative analysis of propensity-matched groups of patients with and without AMI. Results— Patients with AIS (n=864 043) were identified in the national inpatient sample, of whom 13 573 patients (1.6%) had an AMI (79.5% non–ST-segment–elevation myocardial infarction and 20.5% ST-segment–elevation myocardial infarction). In-hospital mortality was 21.4% and 7.1% in propensity-matched cohorts of patients with and without AMI, PP<0.001). However, these were only performed in 7.5% and 2% of patients, respectively. Conclusions— AMI complicating stroke carries a substantial in-hospital mortality and cost of care. Patients who underwent coronary angiography with or without intervention may have improved survival although it was only utilized in a minority of patients. Further studies needed to discern the ideal approach in AMI in patients with AIS.Keywords
This publication has 14 references indexed in Scilit:
- Ten-Year Temporal Trends in Medical Complications After Acute Intracerebral Hemorrhage in the United StatesStroke, 2017
- Accuracy of ICD‐9‐CM Codes by Hospital Characteristics and Stroke Severity: Paul Coverdell National Acute Stroke ProgramJournal of the American Heart Association, 2016
- Trends in Acute Ischemic Stroke Hospitalizations in the United StatesJournal of the American Heart Association, 2016
- Heart Disease and Stroke Statistics—2016 UpdateCirculation, 2016
- Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013The Lancet, 2014
- The Incidence and Risk Factors of Associated Acute Myocardial Infarction (AMI) in Acute Cerebral Ischemic (ACI) Events in the United StatesPLOS ONE, 2014
- Troponin elevation in acute ischemic stroke (TRELAS) - protocol of a prospective observational trialBMC Neurology, 2011
- Predictors of Early Cardiac Morbidity and Mortality After Ischemic StrokeStroke, 2007
- Risk of Myocardial Infarction and Vascular Death After Transient Ischemic Attack and Ischemic StrokeStroke, 2005
- Coding of Stroke and Stroke Risk Factors Using International Classification of Diseases , Revisions 9 and 10Stroke, 2005