Selective risk factors profiles and outcomes among patients with stroke and history of prior myocardial infarction. The European Community Stroke Project

Basile, Anna Maria; Di Carlo, Antonio; Lamassa, Maria; Baldereschi, Marzia; Carlucci, Giovanna; Consoli, Domenico; Wolfe, Charles D.A.; Giroud, Maurice; Inzitari, Domenico; for the European BIOMED Study of Stroke Care Group,

doi:10.1016/j.jns.2007.07.025

« Previous Next »Journal of the Neurological Sciences
Volume 264, Issue 1 , Pages 87-92, 15 January 2008

Selective risk factors profiles and outcomes among patients with stroke and history of prior myocardial infarction. The European Community Stroke Project

Anna Maria Basile
- Department of Neurological and Psychiatric Sciences, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy
- Corresponding author. Tel.: +39 055 42 98 460; fax: +39 055 42 98 461.
Antonio Di Carlo
- Institute of Neurosciences, ILSA Study, Italian National Research Council, Florence, Italy
Maria Lamassa
- Department of Neurological and Psychiatric Sciences, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy
Marzia Baldereschi
- Institute of Neurosciences, ILSA Study, Italian National Research Council, Florence, Italy
Giovanna Carlucci
- Department of Neurological and Psychiatric Sciences, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy
Domenico Consoli
- Department of Neurology, Ospedale “G. Jazzolino”, Vibo Valentia, Italy
Charles D.A. Wolfe
- Department of Public Health Sciences, King's College, London, UK
Maurice Giroud
- Service de Neurologie, Hôpital General, Dijon, France
Domenico Inzitari
- Department of Neurological and Psychiatric Sciences, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy
for the European BIOMED Study of Stroke Care Group

Received 27 November 2006; received in revised form 22 June 2007; accepted 26 July 2007.

Abstract

Background and objective

Previous myocardial infarction (MI) has been linked with poorer stroke outcome. Whether this depends on a greater stroke severity is still uncertain. The aim of the study was to assess the effect of previous MI on characteristics and outcome of stroke in a large hospital cohort of patients.

Methods

In a European Union Concerted Action, patients hospitalized for first-in-a-lifetime stroke were assessed for demographics, risk factors, clinical presentation, and 3-month survival and handicap.

Results

Out of 4190 study patients, 460 (11%) reported a history of MI. Compared with patients without previous MI, those with MI were significantly older, more often males, smokers, alcohol consumers, and with a more severe pre-stroke level of handicap. They had more frequently atrial fibrillation and a history of transient ischemic attack. The acute neurological state and the 28-day mortality did not differ between the two groups. At 3 months, death or severe handicap were more frequent in the MI group (28.3% vs. 21.7%, P=0.001; 74.8% vs. 65.8%, P=0.008). Controlling by logistic regression analysis for age, sex, vascular risk factors, comorbidities, prior to stroke therapy, pre-stroke level of handicap, and clinical acute phase variables, prior MI remained an independent predictor of 3-month death (OR 1.30; 95% CI, 1.02–1.66) and 3-month handicap (OR 1.46; 95% CI, 1.01–2.11).