Why the study?
Does the presence of both acute coronary and cerebrovascular syndromes within a 2-month window increase in-hospital mortality compared to either syndrome alone?
Does the presence of both acute coronary and cerebrovascular syndromes within a 2-month window increase in-hospital mortality compared to either syndrome alone?
Patients with concurrent acute coronary and cerebrovascular syndromes within a 2-month window face a markedly higher risk of early in-hospital death compared to those with either condition alone.
Concurrent ACS and CVS may warrant heightened in-hospital vigilance; this observational link leaves open causal mechanisms and targeted trials.
BACKGROUND: Nationwide evaluations of the epidemiology of acute coronary syndrome (ACS) or cerebrovascular syndrome (CVS) are scarce. We aimed to analyze nationwide French data on patients referred to hospital for either ACS or CVS. METHODS: Using the French national hospital discharge diagnosis records, all patients hospitalized between 2005 and 2008 with a diagnosis of ACS and CVS based on the ICD-10 were identified. We analyzed vascular risk factors and early outcomes in patients with a single hospitalization for ACS or CVS or for both ACV and CVS in a 2-month time window. RESULTS: 1,187,643 patients were recorded. Among these, 638,061 (53.7%) had CVS alone, 525,419 (44.3%) had ACS alone, and 24,163 (2%) had both. Patients of the latter group were older, had a higher prevalence of hypertension, diabetes, and atrial fibrillation, a longer length of stay, were less likely to be discharged to home, and had a higher in-hospital risk of death after adjustment for age, sex, and vascular risk factors compared with patients with either CVS alone (OR = 1.71, 95% CI: 1.66-1.77) or ACS alone (OR = 2.95, 95% CI: 2.85-3.05). CONCLUSION: Patients with both CVS and ACS have a high vascular risk profile and a marked excess risk of early death.
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Béjot et al. (2011) studied this question.
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