Early stroke in patients with acute myocardial infarction: incidence, risk factors and clinical outcomes

ABSTRACT

Limited data is available about stroke developing after acute myocardial infarction [AMI]. We investigated the incidence, risk factors and in-hospital outcome of stroke after AMI in clinical practice with and without use of thrombolysis. We analyzed data from a prospective registry of consecutive patients admitted to the coronary care unit [CCU] at Mubarak Al Kabeer Hospital in Kuwait. Of 2481 patients admitted with AMI between 1999 and 2003, 29 [1.2%] developed stroke during their hospital stay. Age older than 60 years [OR 5.5; 95% Cl 2.4 to 12.5; P< 0.001] and systolic blood pressure higher than 160 mmHg [OR 3.2; 95% Cl 1.lto 9.5; P< 0.04], were identified as independent predictors for stroke among patients with AMI. Patients who received thrombolytic therapy were not at an increased risk for developing stroke [OR 0.7; 95% Cl 0.2 to 2.0]. Patients developing stroke were 12 times more likely to die during hospitalization compared with patients who did not develop stroke [OR 12.6; 95% Cl 5.4 to 26.7; P< 0.001]. Stroke is an infrequent but serious complication of AMI. Older age and high systolic blood pressure at admission are independent predictors of stroke