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

Background There are limited contemporary data prevalence and outcomes of acute ischemic stroke (AIS) complicating acute myocardial infarction (AMI). Methods and Results Adult (>18 years) AMI admissions using the National Inpatient Sample database (2000-2017) were evaluated for in-hospital AIS. Outcomes of interest included in-hospital mortality, hospitalization costs, length of stay, discharge disposition, and use of tracheostomy and percutaneous endoscopic gastrostomy. The discharge destination was used to classify survivors into good and poor outcomes. Of a total 11 622 528 AMI admissions, 183 896 (1.6%) had concomitant AIS. As compared with 2000, in 2017, AIS rates increased slightly among ST-segment-elevation AMI (adjusted odds ratio, 1.10 [95% CI, 1.04-1.15]) and decreased in non-ST-segment-elevation AMI (adjusted odds ratio, 0.47 [95% CI, 0.46-0.49]) admissions (P<0.001). Compared with those without, the AIS cohort was on average older, female, of non-White race, with greater comorbidities, and higher rates of arrhythmias. The AMI-AIS admissions received less frequent coronary angiography (46.9% versus 63.8%) and percutaneous coronary intervention (22.7% versus 41.8%) (P<0.001). The AIS cohort had higher in-hospital mortality (16.4% versus 6.0%; adjusted odds ratio, 1.75 [95% CI, 1.72-1.78]; P<0.001), longer hospital length of stay, higher hospitalization costs, greater use of tracheostomy and percutaneous endoscopic gastrostomy, and less frequent discharges to home (all P<0.001). Among AMI-AIS survivors (N=153 318), 57.3% had a poor functional outcome at discharge with relatively stable temporal trends. Conclusions AIS is associated with significantly higher in-hospital mortality and poor functional outcomes in AMI admissions.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:10

Enthalten in:

Journal of the American Heart Association - 10(2021), 2 vom: 19. Jan., Seite e017693

Sprache:

Englisch

Beteiligte Personen:

Aggarwal, Gaurav [VerfasserIn]
Patlolla, Sri Harsha [VerfasserIn]
Aggarwal, Saurabh [VerfasserIn]
Cheungpasitporn, Wisit [VerfasserIn]
Doshi, Rajkumar [VerfasserIn]
Sundaragiri, Pranathi R [VerfasserIn]
Rabinstein, Alejandro A [VerfasserIn]
Jaffe, Allan S [VerfasserIn]
Barsness, Gregory W [VerfasserIn]
Cohen, Marc [VerfasserIn]
Vallabhajosyula, Saraschandra [VerfasserIn]

Links:

Volltext

Themen:

Acute ischemic stroke
Acute myocardial infarction
Cerebrovascular circulation
Complications
Journal Article
Outcomes research
Research Support, N.I.H., Extramural

Anmerkungen:

Date Completed 14.10.2021

Date Revised 14.10.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1161/JAHA.120.017693

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM319629236