Stroke survivors are nearly twofold more likely to have subsequent myocardial infarction (MI) compared with patients experiencing cervical artery dissection (CAD), according to a study presented at the annual American Stroke Association International Stroke Conference 2024, held from Feb. 7 to 9 in Phoenix.
Lukas Strelecky, from Brown University in Providence, Rhode Island, and colleagues utilized a multistate database to examine MI risk poststroke or post-CAD to estimate cardiovascular complication risk. The analysis included 827,761 patients identified from the State Inpatient Database from New York (2011 to 2017) and Florida (2011 to 2019).
The researchers found that 2.39 percent of all patients had MI within one year, including 1.4 percent of the reference group, 3.4 percent with acute ischemic stroke (AIS), 1.5 percent with CAD, and 1.8 percent of those with concurrent AIS and CAD. Patients with AIS alone and patients with concurrent CAD and AIS had a higher MI risk compared with the reference group (hazard ratio [HR], 4.91; 95 percent confidence interval [CI], 4.63 to 5.21 and HR, 1.67; 95 percent CI, 1.02 to 2.73, respectively). Patients with CAD alone had no elevated risk (HR, 1.17; 95 percent CI, 0.66 to 2.06). Patients with AIS alone still had the highest risk for MI (adjusted HR [aHR], 1.87; 95 percent CI, 1.75 to 1.99), followed by patients with concurrent CAD and AIS (aHR, 1.26; 95 percent CI, 1.05 to 1.5) after adjusting for age, diabetes, heart failure, coronary artery disease, and hyperlipidemia. Patients with CAD had a nonsignificant risk in an adjusted analysis (aHR, 1.142; 95 percent CI, 0.82 to 1.58).
“Before, it was just a guess, but now we know that carotid or vertebral artery dissection not causing a stroke does not raise the risk of a heart attack, and it makes sense that clinicians should focus predominantly on stroke prevention in this subgroup of patients,” coauthor Liqi Shu, M.D., also from Brown University, said in a statement.
Several authors disclosed ties to industry.
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