Long-Term Risk of Ischemic Stroke After Myocardial Infarction

Heart attack
Heart attack
Within one year of the MI event, patients were at an elevated risk of all stroke subtypes.

Patients with myocardial infarction (MI) are at a greater risk of all stroke subtypes within the first year post-event, according to data published in Stroke.

With survival after MI increasing, a greater patient population is now at risk for post-MI stroke. In order to examine the risk for specific stroke subtypes, Jens Sundbøll, MD, of Aarhus University Hospital in Aarhus N, Denmark, and colleagues conducted a nationwide population study using patient medical data from 1980 to 2009. Ultimately, they identified 258 806 patients with a first-time MI and 1 244 773 age- and sex-matched controls.

Cumulative stroke risks 1 to 30 years after the MI event were 12.6% for ischemic stroke, 1.2% for intracerebral hemorrhage (ICH), and 0.24% for subarachnoid hemorrhage (SAH). Thirty days post MI event, the adjusted stroke rate ratio was 30-fold for ischemic stroke (31.9; 95% CI, 28.4–35.8), 20-fold for ICH (21.8; 95% CI, 16.6–28.5), and 15-fold for SAH (16.6; 95% CI, 8.7–32.0). The stroke rate ratio remained elevated during the 31 to 365-day period post-event. One to 30 years after the MI event, risk remained high for ischemic stroke (1.6; 95% CI, 1.6–1.6), but decreased for ICH and SAH.  

The authors hope that this information will help clinicians identify patients at risk for post-MI stroke and engage in preventative strategies.


Sundbøll J, Horváth-puhó E, Schmidt M, et al. Long-Term Risk of Stroke in Myocardial Infarction Survivors: Thirty-Year Population-Based Cohort Study. Stroke. 2016;47(7):1727-33.