Prior ischemic stroke without residual disability (mRS 0-1) increased all-cause mortality by 42% (HR 1.42) compared to no prior stroke in patients with acute myocardial infarction.
Cohort (n=10,084)
Yes
Does prior ischemic stroke, with or without neurological disability, increase long-term mortality in patients with acute myocardial infarction?
Prior ischemic stroke, even without residual neurological disability (mRS 0-1), significantly increases long-term all-cause and cardiovascular mortality in patients presenting with acute myocardial infarction.
Effect estimate: HR 1.42 (95% CI 1.20-1.67)
Absolute Event Rate: 27.7% vs 16.6%
p-value: p=<0.001
Acute myocardial infarction (AMI) patients with a prior stroke face higher in-hospital risks than those with AMI alone, yet the association between neurological status-assessed via the modified Rankin Scale (mRS)-and long-term mortality in AMI patients remains understudied. This retrospective study analyzed 10,084 AMI patients, categorizing them into three groups: no prior stroke, prior ischemic stroke (IS) with mRS 0-1 (no disability), or mRS 2-5 (disability), with mortality tracked via the China National Death Registration System over a median 5.26 years. Among the cohort, 8.9% (n = 893) had prior IS, and 18.1% (n = 1,829) died, including 1,454 cardiovascular deaths. Compared to non-stroke patients, those with prior IS and mRS 0-1 exhibited elevated all-cause (hazard ratio HR = 1.42, 95% CI 1.20-1.67) and cardiovascular mortality (HR = 1.46, 95% CI 1.21-1.76), while the mRS 2-5 group faced significantly higher risks (all-cause: HR = 2.18, 95% CI 1.84-2.60; cardiovascular: HR = 2.10, 95% CI 1.73-2.55), all P < 0.001. Prior IS, even without residual disability, is linked to increased long-term mortality in AMI patients, with the highest risk among those with post-stroke disability. These findings emphasize the need for enhanced secondary prevention strategies to reduce mortality in this high-risk population.
Feng et al. (Sat,) conducted a cohort in Acute myocardial infarction (n=10,084). Prior ischemic stroke without residual disability (mRS 0-1) vs. No prior stroke was evaluated on All-cause mortality (HR 1.42, 95% CI 1.20-1.67, p=<0.001). Prior ischemic stroke without residual disability (mRS 0-1) increased all-cause mortality by 42% (HR 1.42) compared to no prior stroke in patients with acute myocardial infarction.