Study on the incidence and risk factors for in-hospital stroke in patients with acute myocardial infarction / 中华流行病学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To determine the incidence and risk factors for in-hospital stroke in patients with acute myocardial infarction (AMI).</p><p><b>METHODS</b>Two thousand one hundred and thirty-three patients with acute myocardial infarction were studied retrospectively. History, demographic, clinical, thrombolytic and anticoagulant data of AMI were obtained through review of the medical record. The relative risk of in-hospital stroke in patients with AMI was estimated using multiple nonconditional logistic regression to adjust for potential confounding factors.</p><p><b>RESULTS</b>Among 2,133 consecutive patients admitted with acute myocardial infarction to hospitals in Shandong and Hubei provinces, 98 (4.59%) experienced strokes during hospitalization. In our analysis, anterior infarction was the most important risk factor for in-hospital stroke (ischemic and hemorrhagic) in patients with AMI (RR = 7.04), followed by history of hypertension (RR = 3.41), previous stroke (RR = 1.69), atrial fibrillation (RR = 2.22), advanced age (RR = 1.04), and higher heart rate at enrollment (RR = 1.03).</p><p><b>CONCLUSIONS</b>The incidence of in-hospital stroke in patients with AMI increased with lower rate of using thrombolytic agents. Thrombolytic therapy was noticed as a protective factor for stroke after AMI. The risk factors for in-hospital stroke with AMI were history of hypertension, previous stroke, atrial fibrillation, advanced age, anterior infarction, and higher heart rate at enrollment.</p>