Elderly Have High Stroke Risk after Heart Attack

Older patients who suffer a heart attack have a high risk of being hospitalized for stroke within six months of their discharge from the hospital, according to a study conducted by researchers at Yale School of Medicine (New Haven, CT, USA).

The researchers analyzed data from more than 111,000 elderly patients from a geographically diverse sample. They found that, overall, 2.5% were admitted with an ischemic stroke within six months of discharge. Older patients, African Americans, and patients with any frailty are at increased risk of stroke after a heart attack. Conditions associated with higher stroke admission rates included prior stroke, hypertension, diabetes, atrial fibrillation, heart failure, and peripheral vascular disease.

The risk of stroke among the 20% of patients who had at least four of the eight identified factors was four times higher than for patients with none of these factors. Patients in this group had a one in 25 chance of being hospitalized for stroke in the six months after discharge. Aspirin at discharge was associated with reduced stroke admission rates. The study was published in the March 2002 issue of Circulation.

"Our results demonstrate that stroke after myocardial infarction is much more common than previously reported,” said Judith Lichtman, assistant professor, department of epidemiology and public health, who led the study. The new data, noted Dr. Lichtman, can be used to target high-risk patients for more aggressive therapies and counseling, including information about the signs and symptoms of a stroke and the appropriate action if these signs are present.




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