Five‐Year Risk of Acute Myocardial Infarction After Acute Ischemic Stroke in Korea

Abstract

Background The long‐term incidence of acute myocardial infarction (AMI) in patients with acute ischemic stroke (AIS) has not been well defined in large cohort studies of various race‐ethnic groups. Methods and Results A prospective cohort of patients with AIS who were registered in a multicenter nationwide stroke registry (CRCS‐K [Clinical Research Collaboration for Stroke in Korea] registry) was followed up for the occurrence of AMI through a linkage with the National Health Insurance Service claims database. The 5‐year cumulative incidence and annual risk were estimated according to predefined demographic subgroups, stroke subtypes, a history of coronary heart disease (CHD), and known risk factors of CHD. A total of 11 720 patients with AIS were studied. The 5‐year cumulative incidence of AMI was 2.0%. The annual risk was highest in the first year after the index event (1.1%), followed by a much lower annual risk in the second to fifth years (between 0.16% and 0.27%). Among subgroups, annual risk in the first year was highest in those with a history of CHD (4.1%) compared with those without a history of CHD (0.8%). The small‐vessel occlusion subtype had a much lower incidence (0.8%) compared with large‐vessel occlusion (2.2%) or cardioembolism (2.4%) subtypes. In the multivariable analysis, history of CHD (hazard ratio, 2.84; 95% CI, 2.01–3.93) was the strongest independent predictor of AMI after AIS. Conclusions The incidence of AMI after AIS in South Korea was relatively low and unexpectedly highest during the first year after stroke. CHD was the most substantial risk factor for AMI after stroke and conferred an approximate 5‐fold greater risk.

Cardio-Cerebral infarction syndrome: definition, diagnosis, pathophysiology, and treatment

“…The 5-year cumulative incidence of acute myocardial infarction was 2%, incidence of AMI was highest in the first year and especially during the first 2 months after AIS. Notably, patients with history of coronary heart disease showed a 5-fold risk of acute myocardial infarction after stroke onset, and those with cardioembolism subtype had a higher risk than other subtypes [7]. Also, poststroke cardiac arrhythmias could be another possible cause of AMI after AIS.…”

“…The annual risk was highest in the first year after the index event (1.1%), followed by a much lower annual risk in the second to fifth years (between 0.16% and 0.27%. Coronary heart disease was the most substantial risk factor for AMI after stroke and conferred an approximate 5-fold greater risk [7].…”

Cardio-Cerebral Infarction Syndrome (CCIS): Definition, Diagnosis, Pathophysiology and Treatment

“…Notably, patients with history of coronary heart disease showed a 5-fold risk of acute myocardial infarction after stroke onset, and those with cardio-embolism subtype had a higher risk than other subtypes. [7]. Also, poststroke cardiac arrhythmias could be another possible cause of AMI after AIS (table 3).…”

“…Coronary heart disease was the most substantial risk factor for AMI after ischemic stroke and conferred an approximate 5-fold greater risk. [7] Both AIS and AMI are medical emergency conditions, which require rapid diagnosis and treatment. According to new trial the incidence of AMI patients who diagnosed acute ischemic stroke about 0.009%.…”

Cardio-Cerebral Infarction Syndrome: An Overview

“…Coronary heart disease was the most substantial risk factor for AMI after ischemic stroke and conferred an approximate 5-fold greater risk. [7] Both AIS and AMI are medical emergency conditions, which require rapid diagnosis and treatment. The incidence of AMI patients who diagnosed acute ischemic stroke about 0.009%.…”