Temporal Trends, Predictors, and Outcomes of Acute Ischemic Stroke in Acute Myocardial Infarction in the United States

Figure 1. Trends in the prevalence and in‐hospital mortality with and without AIS in AMI admissions. A, Unadjusted temporal trends of the proportion of AMI admissions with AIS overall and stratified by type of AMI (P<0.001 for trend over time); (B) Adjusted odds ratio* for AIS in STEMI and NSTEMI admissions by year (with 2000 as the referent) (P<0.001 for trend over time); (C) Unadjusted in‐hospital mortality in AMI admissions stratified by type of AMI and the presence of AIS (P<0.001 for trend over time); (D) Adjusted odds ratio* for in‐hospital mortality by year (with 2000 as the referent) in AMI admissions stratified by type of AMI and the presence of AIS (P<0.001 for trend over time). *Adjusted for age, sex, race, comorbidity, primary payer, hospital region, hospital location and teaching status, hospital bed size, acute organ failure, cardiogenic shock, atrial fibrillation/flutter, cardiac arrest, coronary angiography, percutaneous coronary intervention, coronary artery bypass grafting, pulmonary artery catheterization, use of fibrinolytic, coronary thrombectomy, vascular complications, mechanical circulatory support, invasive mechanical ventilation, and acute hemodialysis. AIS…

Figure 2. Subgroup analyses for in‐hospital mortality in AMI admissions with AIS compared with those without AIS stratified by type of AMI. Multivariable adjusted odds ratios (95% CIs) for in‐hospital mortality in STEMI (A) and NSTEMI (B) admissions with AIS compared with admissions without AIS; all P<0.001. Each subgroup was adjusted for age, sex, race, comorbidity, primary payer, hospital region, hospital location and teaching status, hospital bed size, acute organ failure, cardiogenic shock, atrial fibrillation/flutter, cardiac arrest, coronary angiography, percutaneous coronary intervention, coronary artery bypass grafting, pulmonary artery catheterization, use of fibrinolytic, coronary thrombectomy, vascular complications, mechanical circulatory support, invasive mechanical ventilation, and acute hemodialysis. AIS indicates acute ischemic stroke; AMI, acute myocardial infarction; CABG, coronary artery bypass grafting; IHM, in‐hospital mortality; NSTEMI, non–ST‐segment–elevation myocardial infarction; PCI, percutaneous coronary intervention; and STEMI, ST‐segment–elevation myocardial infarction.

Figure 3. Trends in the prevalence of poor functional outcomes in AIS survivors. A, Unadjusted temporal trends of the proportion of patients with AMI‐AIS with poor functional outcome stratified by type of AMI (P<0.001 for trend over time); (B) Adjusted odds ratio for poor functional outcome in STEMI and NSTEMI admissions by year (with 2000 as the referent); adjusted for age, sex, race, comorbidity, primary payer, hospital region, hospital location and teaching status, and hospital bed size, acute organ failure, atrial fibrillation/flutter, cardiogenic shock, cardiac arrest, coronary angiography, percutaneous coronary intervention, coronary artery bypass grafting, pulmonary artery catheterization, mechanical circulatory support, invasive mechanical ventilation, and acute hemodialysis (P<0.001 for trend over time). AIS indicates acute ischemic stroke; AMI, acute myocardial infarction; NSTEMI, non–ST‐segment–elevation myocardial infarction; and STEMI, ST‐segment–elevation myocardial infarction.