Cargando…

Risk Factors for Ischemic Stroke After Acute Coronary Syndrome

BACKGROUND: Stroke incidence is elevated after acute coronary syndromes (ACS). The aim of this study was to characterize risk factors related to ischemic stroke (IS) after ACS. METHODS AND RESULTS: We conducted a retrospective registry study based on the data of 8049 consecutive patients treated for...

Descripción completa

Detalles Bibliográficos
Autores principales: Hurskainen, Matilda, Tynkkynen, Juho, Eskola, Markku, Lehtimäki, Terho, Hernesniemi, Jussi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382101/
https://www.ncbi.nlm.nih.gov/pubmed/37421266
http://dx.doi.org/10.1161/JAHA.122.028787
_version_ 1785080609598603264
author Hurskainen, Matilda
Tynkkynen, Juho
Eskola, Markku
Lehtimäki, Terho
Hernesniemi, Jussi
author_facet Hurskainen, Matilda
Tynkkynen, Juho
Eskola, Markku
Lehtimäki, Terho
Hernesniemi, Jussi
author_sort Hurskainen, Matilda
collection PubMed
description BACKGROUND: Stroke incidence is elevated after acute coronary syndromes (ACS). The aim of this study was to characterize risk factors related to ischemic stroke (IS) after ACS. METHODS AND RESULTS: We conducted a retrospective registry study based on the data of 8049 consecutive patients treated for ACS between 2007 and 2018 in Tays Heart Hospital with a follow‐up until December 31, 2020. Potential risk factors were identified by in‐depth review of written hospital records and causes‐of‐death registry data maintained by Statistics Finland. The association between individual risk factors, early‐onset IS (0–30 days after ACS, n=82), and late‐onset IS (31 days to 14 years after ACS, n=419) were analyzed using logistic regression and subdistribution hazard analysis. In multivariable analysis, the most substantial risk factors for early‐ and late‐onset IS were previous stroke, atrial fibrillation or flutter, and heart failure status depicted by the Killip classification. Left ventricular ejection fraction and coronary artery disease severity were significant risk factors for early‐onset IS; age and peripheral artery disease were significant risk factors for late‐onset IS. The risk of early‐onset IS with ≥6 CHA(2)DS(2)‐VASc score points (odds ratio, 6.63 [95% Cl, 3.63–12.09]; P<0.001) was notable compared with patients with 1 to 3 points as well as the risk of late‐onset IS with ≥6 points (subdistribution hazard, 6.03 [95% Cl, 3.71–9.81]; P<0.001) in comparison with patients with 1 point. CONCLUSIONS: Factors related to high thromboembolic risk also predict IS risk after ACS. CHA(2)DS(2)‐VASc score and its individual components are strong predictors for both early‐ and late‐onset IS.
format Online
Article
Text
id pubmed-10382101
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-103821012023-07-29 Risk Factors for Ischemic Stroke After Acute Coronary Syndrome Hurskainen, Matilda Tynkkynen, Juho Eskola, Markku Lehtimäki, Terho Hernesniemi, Jussi J Am Heart Assoc Original Research BACKGROUND: Stroke incidence is elevated after acute coronary syndromes (ACS). The aim of this study was to characterize risk factors related to ischemic stroke (IS) after ACS. METHODS AND RESULTS: We conducted a retrospective registry study based on the data of 8049 consecutive patients treated for ACS between 2007 and 2018 in Tays Heart Hospital with a follow‐up until December 31, 2020. Potential risk factors were identified by in‐depth review of written hospital records and causes‐of‐death registry data maintained by Statistics Finland. The association between individual risk factors, early‐onset IS (0–30 days after ACS, n=82), and late‐onset IS (31 days to 14 years after ACS, n=419) were analyzed using logistic regression and subdistribution hazard analysis. In multivariable analysis, the most substantial risk factors for early‐ and late‐onset IS were previous stroke, atrial fibrillation or flutter, and heart failure status depicted by the Killip classification. Left ventricular ejection fraction and coronary artery disease severity were significant risk factors for early‐onset IS; age and peripheral artery disease were significant risk factors for late‐onset IS. The risk of early‐onset IS with ≥6 CHA(2)DS(2)‐VASc score points (odds ratio, 6.63 [95% Cl, 3.63–12.09]; P<0.001) was notable compared with patients with 1 to 3 points as well as the risk of late‐onset IS with ≥6 points (subdistribution hazard, 6.03 [95% Cl, 3.71–9.81]; P<0.001) in comparison with patients with 1 point. CONCLUSIONS: Factors related to high thromboembolic risk also predict IS risk after ACS. CHA(2)DS(2)‐VASc score and its individual components are strong predictors for both early‐ and late‐onset IS. John Wiley and Sons Inc. 2023-07-08 /pmc/articles/PMC10382101/ /pubmed/37421266 http://dx.doi.org/10.1161/JAHA.122.028787 Text en © 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Hurskainen, Matilda
Tynkkynen, Juho
Eskola, Markku
Lehtimäki, Terho
Hernesniemi, Jussi
Risk Factors for Ischemic Stroke After Acute Coronary Syndrome
title Risk Factors for Ischemic Stroke After Acute Coronary Syndrome
title_full Risk Factors for Ischemic Stroke After Acute Coronary Syndrome
title_fullStr Risk Factors for Ischemic Stroke After Acute Coronary Syndrome
title_full_unstemmed Risk Factors for Ischemic Stroke After Acute Coronary Syndrome
title_short Risk Factors for Ischemic Stroke After Acute Coronary Syndrome
title_sort risk factors for ischemic stroke after acute coronary syndrome
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382101/
https://www.ncbi.nlm.nih.gov/pubmed/37421266
http://dx.doi.org/10.1161/JAHA.122.028787
work_keys_str_mv AT hurskainenmatilda riskfactorsforischemicstrokeafteracutecoronarysyndrome
AT tynkkynenjuho riskfactorsforischemicstrokeafteracutecoronarysyndrome
AT eskolamarkku riskfactorsforischemicstrokeafteracutecoronarysyndrome
AT lehtimakiterho riskfactorsforischemicstrokeafteracutecoronarysyndrome
AT hernesniemijussi riskfactorsforischemicstrokeafteracutecoronarysyndrome