Immediate and one-year outcome of patients presenting with Acute Coronary Syndrome complicated by stroke: Findings from the 2ndGulf Registry of Acute Coronary Events (Gulf RACE-2)

Abstract

BackgroundStroke is a potential complication of acute coronary syndrome (ACS). The aim of this study was to identify the prevalence, risk factors predisposing to stroke, in-hospital and 1-year mortality among patients presenting with ACS in the Middle East.MethodsFor a period of 9 months in 2008 to 2009, 7,930 consecutive ACS patients were enrolled from 65 hospitals in 6 Middle East countries.ResultsThe prevalence of in-hospital stroke following ACS was 0.70%. Most cases were ST segment elevation MI-related (STEMI) and ischemic stroke in nature. Patients with in-hospital stroke were 5 years older than patients without stroke and were more likely to have hypertension (66% vs. 47.6%, P = 0.001). There were no differences between the two groups in regards to gender, other cardiovascular risk factors, or prior cardiovascular disease. Patients with stroke were more likely to present with atypical symptoms, advanced Killip class and less likely to be treated with evidence-based therapies. Independent predictors of stroke were hypertension, advanced killip class, ACS type –STEMI and cardiogenic shock. Stroke was associated with increased risk of in-hospital (39.3% vs. 4.3%) and one-year mortality (52% vs. 12.3%).ConclusionThere is low incidence of in-hospital stroke in Middle-Eastern patients presenting with ACS but with very high in-hospital and one-year mortality rates. Stroke patients were less likely to be appropriately treated with evidence-based therapy. Future work should be focused on reducing the risk and improving the outcome of this devastating complication.

Frequency and Predictors of Stroke After Acute Myocardial Infarction

“…[3][4][5] Despite the improvement in reperfusion strategies and the management of cardiovascular risk factors, ischemic stroke (IS) after AMI remains associated with worse short-term and 1-year mortality (30.1% and 36.5%, respectively) when compared with patients without stroke. 6,7 Stroke occurred more frequently in the first days after AMI, but incidence progressively decreased over time.…”

Risk of Stroke After Exacerbation of Ischemic Heart Disease: Data of 3‑Years Follow-up

“…Кардиология. 2018;58 (7). ИШЕМИЧЕСКАЯ БОЛЕЗНЬ СЕРДЦА § Всего были включены 1 193 больных с нестабильной стенокардией (НС) и инфарктом миокарда (ИМ) с подъе мом и без подъема сегмента ST. Подробно критерии включения в исследование описаны в предыдущих публикациях [5].…”

“…Целью исследования был анализ возможной ассоциации клинических и генетических факторов с развитием инсульта у больных, перенесших обострение ИБС. (7): [14][15][16][17][18][19][20][21][22].…”

Stroke Complicating Acute ST Elevation Myocardial Infarction—Current Concepts

“…13,14 Recent studies quote the incidence of stroke after acute MI anywhere between 0.7 and 2.2%. [15][16][17] The short-term and 1-year mortalities are 30.1 and 36.5% when MI is complicated by ischemic stroke. 18,19 Hemorrhagic stroke is less frequent (0.06-0.22%), 20 but the mortality is higher (65.4% at 30 days and 71.8% at 1 year) (►Table 2).…”