Key result
Recent MI within 3 months in older acute ischemic stroke patients receiving rtPA was associated with higher in-hospital mortality compared to no MI history (17.4% vs 9.0%; OR 1.60; P=0.014).
Why the study?
Intravenous rtPA improves outcomes in acute ischemic stroke, but its safety in patients with a history of recent myocardial infarction remains controversial.
Does recent myocardial infarction increase the risk of in-hospital mortality and rtPA-related complications in older adults with acute ischemic stroke receiving thrombolytic therapy?
Cohort (n=40,396)
Yes
Does recent myocardial infarction increase the risk of in-hospital mortality and rtPA-related complications in older adults with acute ischemic stroke receiving thrombolytic therapy?
Effect estimate: OR 1.60 (95% CI 1.10-2.33)
Absolute Event Rate: 17.4% vs 9%
p-value: p=0.014
In older adults receiving thrombolytic therapy for acute ischemic stroke, a recent myocardial infarction within 3 months is associated with a significantly increased risk of in-hospital mortality.
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Recent MI may signal elevated rtPA mortality risk in older stroke patients; leaves open whether to alter eligibility thresholds.
Inohara et al. (2019) conducted a cohort in Acute ischemic stroke (n=40,396). Recent myocardial infarction (within 3 months) vs. No history of myocardial infarction was evaluated on In-hospital mortality (OR 1.60, 95% CI 1.10-2.33, p=0.014). Recent MI within 3 months in older acute ischemic stroke patients receiving rtPA was associated with higher in-hospital mortality compared to no MI history (17.4% vs 9.0%; OR 1.60; P=0.014).
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