title: Selective risk factors profiles and outcomes among patients with stroke and history of prior myocardial infarction. The European Community Stroke Project.
abstract: OBJECTIVE
  Previous myocardial infarction (MI) has been linked with poorer stroke outcome. Whether this depends on a greater stroke severity is still uncertain. The aim of the study was to assess the effect of previous MI on characteristics and outcome of stroke in a large hospital cohort of patients.
  
  
  METHODS
  In a European Union Concerted Action, patients hospitalized for first-in-a-lifetime stroke were assessed for demographics, risk factors, clinical presentation, and 3-month survival and handicap.
  
  
  RESULTS
  Out of 4190 study patients, 460 (11%) reported a history of MI. Compared with patients without previous MI, those with MI were significantly older, more often males, smokers, alcohol consumers, and with a more severe pre-stroke level of handicap. They had more frequently atrial fibrillation and a history of transient ischemic attack. The acute neurological state and the 28-day mortality did not differ between the two groups. At 3 months, death or severe handicap were more frequent in the MI group (28.3% vs. 21.7%, P=0.001; 74.8% vs. 65.8%, P=0.008). Controlling by logistic regression analysis for age, sex, vascular risk factors, comorbidities, prior to stroke therapy, pre-stroke level of handicap, and clinical acute phase variables, prior MI remained an independent predictor of 3-month death (OR 1.30; 95% CI, 1.02-1.66) and 3-month handicap (OR 1.46; 95% CI, 1.01-2.11).
  
  
  CONCLUSIONS
  Previous MI has no impact on clinical severity of acute stroke, but significantly affects 3-month outcome in terms of handicap and mortality.
authors.affiliation: Department of Neurological and Psychiatric Sciences, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy. annamaria.basile@unipd.it
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Basile
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Carlo
authors.forename: Maria
authors.initials: M
authors.lastname: Lamassa
authors.forename: Marzia
authors.initials: M
authors.lastname: Baldereschi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Carlucci
authors.forename: Domenico
authors.initials: D
authors.lastname: Consoli
authors.forename: Charles D A
authors.initials: CD
authors.lastname: Wolfe
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D018450:Disease Progression; D005062:European Union; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000401:mortality*; D000071939:Stroke Rehabilitation; D015996:Survival Rate; D016896:Treatment Outcome