PMID: 2117618Sep 1, 1990Paper

Stroke and acute myocardial infarction in the thrombolytic era: clinical correlates and long-term prognosis

Journal of the American College of Cardiology
C M O'ConnorL Aronson

Abstract

Thirteen (1.8%) of 708 patients with acute myocardial infarction treated with recombinant tissue-type plasminogen activator in the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) I, II and III trials developed a stroke. Four strokes were hemorrhagic and nine were nonhemorrhagic. Of five prespecified risk factors for intracranial hemorrhage (age greater than 65 years, history of hypertension, history of prior cerebrovascular disease, aspirin use and acute hypertension), two patients had two risk factors and one patient had one risk factor. However, 80% of patients without intracranial hemorrhage had at least one risk factor and 31% had two risk factors. No patient with a prior stroke or transient ischemic attack (all greater than 6 months previously) had an intracranial hemorrhage. Of three prespecified risk factors for nonhemorrhagic stroke (atrial fibrillation, prior cerebrovascular disease and large anterior wall infarction), only the occurrence of a large anterior myocardial infarction (with ejection fraction less than 45%) was a predictor (p = 0.0015). The in-hospital death rate was 25% for patients with hemorrhagic stroke versus 11% for patients with a non-hemorrhagic stroke and 6% for those patients without a...Continue Reading

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Citations

Aug 22, 2001·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·J M Estess, D J Moliterno
Sep 1, 1990·Journal of the American College of Cardiology·M A Sloan, G D Plotnick
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Feb 27, 2007·Vascular Health and Risk Management·Reza Tabrizchi
Sep 4, 2004·Neurosurgical Focus·Alfredo Quinones-HinojosaMichael T Lawton
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Mar 1, 1994·The American Journal of Cardiology·W B HillegassD B Mark
Jan 6, 2005·American Heart Journal·Michael A Sloan
Dec 31, 1993·Annals of the New York Academy of Sciences·B J McNeil
Jun 22, 2000·Coronary Artery Disease·G E Lane, D R Holmes
Feb 15, 1992·Hospital Practice·C M O'Connor, R M Califf
Jul 1, 1999·Clinics in Chest Medicine·G S Francis

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