Factors associated with development of stroke long-term after myocardial infarction: experiences from the LoWASA trial.
OBJECTIVE
To describe factors associated with the development of stroke during long-term follow-up after acute myocardial infarction (AMI) in the LoWASA trial.


METHODS
Patients who had been hospitalized for AMI were randomized within 42 days to receive either warfarin 1.25 mg plus aspirin 75 mg daily or aspirin 75 mg alone.


METHODS
The study was performed according to the probe design, that is open treatment and blinded end-point evaluation.


METHODS
The study was performed in 31 hospitals in Sweden. The mean follow-up time was 5.0 years with a range of 1.7-6.7 years.


RESULTS
In all, 3300 patients were randomized in the trial, of which 194 (5.9%) developed stroke (4.2% nonhaemorrhagic, 0.5% haemorrhagic and 1.3% uncertain. The following factors appeared as independent predictors for an increased risk of stroke: age, hazard ratio and 95% confidence interval (1.07; 1.05-1.08), a history of diabetes mellitus (2.4; 1.8-3.4), a history of stroke (2.3; 1.5-3.5), a history of hypertension (2.0; 1.5-2.7) and a history of smoking (1.5;1.1-2.0). Most of these factors were also predictors of a nonhaemorrhagic stroke whereas no predictor of haemorrhagic stroke was found.


CONCLUSIONS
Risk indicators for stroke long-term after AMI were increasing age, a history of either diabetes mellitus, stroke, hypertension or smoking.
Herlitz
J
J
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. johan.herlitz@hik.gu.se
Holm
J
J
Peterson
M
M
Karlson
B W
BW
Evander
M Haglid
MH
Erhardt
L
L
D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control; D013997:Time Factors; D014859:Warfarin / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D014859:Warfarin; D001241:Aspirin