Abstract
Abstract 13794: Prevalence, Treatment Patterns and Outcomes of Acute Myocardial Infarction in Hospitalizations With Acute Ischemic Stroke - A Nationwide Analysis
Circulation (New York, N.Y.), Vol.144(S_1), p.A13794
11/16/2021
DOI: 10.1161/circ.144.suppl_1.13794
Abstract
Byline: Aakash Sheth, Internal Medicine, LSU Health Sciences Cntr - Shreveport, Shreveport, LA; Harsh P Patel, Louis A Weiss Memorial Hosp, Chicago, IL; Udhayvir Grewal, Internal Medicine, LSU Health Sciences Cntr - Shreveport, Shreveport, LA; Samarthkumar Thakkar, Internal Medicine, Rochester General Hosp, Rochester, NY; Terek Helmy, Cardiology, LSU Health Sciences Cntr - Shreveport, Shreveport, LA; Paari Dominic, Cardiology, LSU Health Sciences Cntr - Shreveport, LA Introduction: AHA/ASA guidelines recommend measuring troponin in patients with acute ischemic stroke (AIS) to monitor for acute myocardial infarction (AMI). However, large scale data on the prevalence and outcomes of AMI complicating AIS are lacking. Hypothesis: AMI in patients with AIS is associated with poorer outcomes. Methods: All patients with principal diagnosis of AIS with and without AMI were identified in the Nationwide Inpatient Sample from 2005 to 2018. Using Jonckheere-Terpstra test, propensity score matching, and univariate and multivariate logistic regression, trends of prevalence of STEMI and NSTEMI, in-hospital outcomes, and treatment patterns were obtained and compared between the AIS groups with and without AMI. Results: A total of 5,329,107 hospitalizations with AIS were identified, of which 117,955 hospitalizations had AMI (20,289 STEMI and 97,756 NSTEMI). The prevalence of STEMI decreased while that of NSTEMI increased significantly over time. After propensity score matching, the AIS group with AMI had higher all-cause in-hospital mortality (11.42% vs 3.51%; p<0.0001), and a higher occurrence of adverse events (hemorrhagic transformation: 5.99% vs 4.31; p<0.0001, craniotomy: 0.12% vs 0.06%; p<0.0009) compared to the group without AMI. Among AIS patients, those with STEMI had higher all-cause in-hospital mortality (29.89% vs 15.57%; p<0.0001). After adjusting for baseline characteristics, the AMI group that received cardiac catheterization and percutaneous coronary intervention had lower in-hospital mortality (7.49% vs 18.93%; p < 0.0001) than the group that did not receive cardiac intervention. However, only 7.8% hospitalizations with AMI after AIS received cardiac interventions. Conclusions: Patients with AMI after AIS that underwent coronary angiography with or without intervention have improved survival. Large scale studies are needed to further prove the utility of cardiac intervention in these patients.
Details
- Title: Subtitle
- Abstract 13794: Prevalence, Treatment Patterns and Outcomes of Acute Myocardial Infarction in Hospitalizations With Acute Ischemic Stroke - A Nationwide Analysis
- Creators
- Aakash ShethHarsh P PatelUdhayvir GrewalSamarthkumar ThakkarTerek HelmyPaari Dominic
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.144(S_1), p.A13794
- Publisher
- Lippincott Williams & Wilkins, WK Health
- DOI
- 10.1161/circ.144.suppl_1.13794
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 11/16/2021
- Description audience
- Professional
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984367256302771
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