title: Risk of ischemic stroke after an acute myocardial infarction in patients with diabetes mellitus.
abstract: BACKGROUND
  Incidence, any trend over time, and predictors of ischemic stroke after an acute myocardial infarction (AMI) in diabetic patients are unknown.
  
  
  RESULTS
  Data for 173,233 unselected patients with an AMI, including 33,503 patients with diabetes mellitus, were taken from the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA) during 1998 to 2008. Ischemic stroke events were recorded during 1 year of follow-up. Patients with diabetes mellitus more often had a history of cardiovascular disease, received less reperfusion therapy, and were treated with acetylsalicylic acid, P2Y12 inhibitors, and statins to a lesser extent compared with patients without diabetes mellitus. However, the use of evidence-based therapies increased markedly in both groups during the study period. The incidence of ischemic stroke during the first year after AMI decreased from 7.1% to 4.7% in patients with diabetes mellitus and from 4.2% to 3.7% in patients without diabetes mellitus. Risk reduction was significantly larger in the diabetic subgroup. Reperfusion therapy, acetylsalicylic acid, P2Y12 inhibitors, and statins were independently associated with the reduced stroke risk.
  
  
  CONCLUSIONS
  Ischemic stroke is a fairly common complication after an AMI in patients with diabetes mellitus, but the risk of stroke has decreased during recent years. The increased use of evidence-based therapies contributes importantly to this risk reduction, but there is still room for improvement.
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Sweden.
authors.forename: Stina
authors.initials: S
authors.lastname: Jakobsson
authors.forename: Lisa
authors.initials: L
authors.lastname: Bergström
authors.forename: Fredrik
authors.initials: F
authors.lastname: Björklund
authors.forename: Tomas
authors.initials: T
authors.lastname: Jernberg
authors.forename: Lars
authors.initials: L
authors.lastname: Söderström
authors.forename: Thomas
authors.initials: T
authors.lastname: Mooe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use; D048909:Diabetes Complications / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy; D015425:Myocardial Reperfusion; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control*; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D001241:Aspirin
keywords: diabetes mellitus; myocardial infarction; stroke