Incidence and characteristics of stroke during 90-day follow-up in patients stabilized after an acute coronary syndrome

American Heart Journal
Hassan Kassem-MoussaSYMPHONY and 2nd SYMPHONY Investigators

Abstract

Stroke is a rare but serious event that complicates the course of patients with acute coronary syndromes (ACS). The type, outcome, and risk factors of stroke occurring in stabilized patients with ACS have not been previously reported. We evaluated stroke incidence, subtypes, and outcomes, in addition to demographics and clinical risk characteristics associated with stroke among patients enrolled in the Sibrafiban versus Aspirin to Yield Maximum Protection from Ischemic Heart Events Post-acute Coronary Syndromes (SYMPHONY) and 2nd SYMPHONY trials. Of 15,904 stabilized patients with ACS, 113 (0.71%) had a stroke over a median follow-up of 90 days. The majority of strokes occurred within 30 days of presentation, and the time course for stroke occurrence paralleled that of myocardial (re)infarction. Most strokes were ischemic (78%), and 52% resulted in moderate or severe disability or death. Patients with stroke were older and more often had hypertension, diabetes, peripheral vascular disease, and atrial fibrillation. Among patients with stroke who had cardiac catheterization, percutaneous coronary intervention, or coronary artery bypass grafting, stroke occurred predominantly after the procedure. No difference in occurrence or typ...Continue Reading

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Citations

Oct 26, 2012·Current Treatment Options in Neurology·Giuseppe Di PasqualeSimona Gambetti
Jun 19, 2007·Acute Cardiac Care·Gulmira Kudaiberdieva, Bulent Gorenek
Aug 9, 2011·Stroke Research and Treatment·M Àngels FontAdrià Arboix
Sep 27, 2014·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Scott J HoffmanRajiv Gulati
Apr 28, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Masaomi GohbaraKazuo Kimura
May 7, 2016·Cardiology Clinics·Marius HornungHorst Sievert
Aug 5, 2006·Cerebrovascular Diseases·Monisha DuttaSteven R Steinhubl
Oct 22, 2016·European Heart Journal. Acute Cardiovascular Care·Federico GuerraAlessandro Capucci
Apr 29, 2006·Stroke; a Journal of Cerebral Circulation·Cheryl D BushnellJ Donald Easton
Dec 21, 2018·Journal of the American Heart Association·Alexander E MerklerHooman Kamel

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