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Five-Year Risk of Acute Myocardial Infarction After Acute Ischemic Stroke in Korea

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Affiliated Author(s)
손성일홍정호
Alternative Author(s)
Sohn, Sung IlHong, Jeong Ho
Journal Title
Journal of the American Heart Association
ISSN
2047-9980
Issued Date
2021
Keyword
acute ischemic strokeacute myocardial infarctioncoronary heart diseaseprospective cohort studyrisk factors
Abstract
Background:
The long‐term incidence of acute myocardial infarction (AMI) in patients with acute ischemic stroke (AIS) has not been well defined in large cohort studies of various race‐ethnic groups.

Methods and Results:
A prospective cohort of patients with AIS who were registered in a multicenter nationwide stroke registry (CRCS‐K [Clinical Research Collaboration for Stroke in Korea] registry) was followed up for the occurrence of AMI through a linkage with the National Health Insurance Service claims database. The 5‐year cumulative incidence and annual risk were estimated according to predefined demographic subgroups, stroke subtypes, a history of coronary heart disease (CHD), and known risk factors of CHD. A total of 11 720 patients with AIS were studied. The 5‐year cumulative incidence of AMI was 2.0%. The annual risk was highest in the first year after the index event (1.1%), followed by a much lower annual risk in the second to fifth years (between 0.16% and 0.27%). Among subgroups, annual risk in the first year was highest in those with a history of CHD (4.1%) compared with those without a history of CHD (0.8%). The small‐vessel occlusion subtype had a much lower incidence (0.8%) compared with large‐vessel occlusion (2.2%) or cardioembolism (2.4%) subtypes. In the multivariable analysis, history of CHD (hazard ratio, 2.84; 95% CI, 2.01–3.93) was the strongest independent predictor of AMI after AIS.

Conclusions:
The incidence of AMI after AIS in South Korea was relatively low and unexpectedly highest during the first year after stroke. CHD was the most substantial risk factor for AMI after stroke and conferred an approximate 5‐fold greater risk.
Department
Dept. of Neurology (신경과학)
Publisher
School of Medicine (의과대학)
Citation
Keon-Joo Lee et al. (2021). Five-Year Risk of Acute Myocardial Infarction After Acute Ischemic Stroke in Korea. Journal of the American Heart Association, 10(1), e018807. doi: 10.1161/JAHA.120.018807
Type
Article
ISSN
2047-9980
DOI
10.1161/JAHA.120.018807
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43453
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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