Clinical features of patients with a myocardial infarction during acute management of an ischemic stroke.
OBJECTIVE
Ischemic stroke and myocardial infarction (MI) share some common risk factors and pathophysiological mechanisms. In addition, brain injury has been associated with abnormalities of heart function such as increased cardiac enzymes and EKG changes. However, there is little information on patients with post-stroke MI. In this study, we investigated the characteristics of ischemic stroke patients who had a MI during the acute stroke period.


METHODS
One thousand three hundred fifty-seven patients with acute ischemic stroke were studied by retrospective review of the stroke registry and inpatient charts. Among these patients, 12 that developed a post-stroke MI, during acute stroke management, were included in this study. The stroke subtype, pattern of arterial stenosis, and lesional dominance were analyzed.


RESULTS
The overall frequency of a post-stroke MI during hospitalization was 0.9% (12 of 1,357 patients initially studied). Eight of the 12 patients included had a painless MI. Significant intracranial arterial stenosis was observed in 10 patients (83%). According to the TOAST classification, seven patients (58.3%) had large artery atherosclerosis, three patients were classified as undetermined etiology and two patients were divided into the lacunar and cardioembolic group. Acute ischemia of the insular region was noted in six patients. Five patients died from their cardiac complications during the hospital stay.


CONCLUSIONS
Post-stroke MI can be a potential complication of acute ischemic stroke; these events have a high mortality. Routine EKG monitoring, during the acute stroke period, may improve patient outcome due to the possibility of a painless post-stroke MI.
Lee
Seung-Jae
SJ
Department of Neurology, The Catholic University of Korea, Kangnam St. Mary's Hospital, 505, Banpo-dong, Seocho-gu, Seoul, 137-701, South Korea.
Lee
Kwang-Soo
KS
Kim
Yeong-In
YI
An
Jae-Young
JY
Kim
Woojun
W
Kim
Joong-Seok
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications* / Q000473:pathology / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000473:pathology / Q000628:therapy