Long-Term Risk of Ischemic Stroke After Myocardial Infarction

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.

Reference

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.