title: The Impact of Myocardial Infarction vs. Pneumonia on Outcome in Acute Ischemic Stroke.
abstract: The aim of this study was to examine the association between MI and PNA in the setting of acute ischemic stroke and patient outcome. Eligible patients were identified from a prospectively collected stroke registry and included if transthoracic echocardiography (TTE) was performed during their inpatient stay. 426 patients met inclusion criteria (mean age 64, 73% Black, 48% female). Twenty-one patients (4.9%) experienced an MI. Patients who later suffered a MI initially presented with more severe strokes (median NIHSS 7 vs. 5, p=0.014). More patients in the MI group experienced pneumonia (26% vs. 9%, p=0.004). After adjusting for age, baseline glucose and NIHSS, the odds of in-hospital mortality for patients with MI was 3 times that of those without MI (OR 3.2 95% CI 1.1-9.7, p=0.036). When adjustment was made for pneumonia, age, baseline glucose and NIHSS, MI was no longer significantly related to in-hospital mortality (OR 2.5 95% CI 0.8-8.2, p=0.131). In our sample, while MI was significantly associated with in-hospital mortality, this association was attenuated after adjusting for presence of pneumonia. Our findings raise the question as to whether the prevention of pneumonia could improve in-hospital mortality among patients who experience MI in the setting of ischemic stroke.
authors.affiliation: Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA 70112 (TLM, DM, AJG, EJ, SMS); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (KCA, AKB); Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE) (KCA); Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC) (KCA); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (TMB).
authors.forename: Tiffany L
authors.initials: TL
authors.lastname: Mathias
authors.affiliation: Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA 70112 (TLM, DM, AJG, EJ, SMS); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (KCA, AKB); Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE) (KCA); Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC) (KCA); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (TMB).
authors.forename: Karen C
authors.initials: KC
authors.lastname: Albright
authors.affiliation: Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA 70112 (TLM, DM, AJG, EJ, SMS); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (KCA, AKB); Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE) (KCA); Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC) (KCA); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (TMB).
authors.forename: Amelia K
authors.initials: AK
authors.lastname: Boehme
authors.affiliation: Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA 70112 (TLM, DM, AJG, EJ, SMS); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (KCA, AKB); Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE) (KCA); Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC) (KCA); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (TMB).
authors.forename: Dominique
authors.initials: D
authors.lastname: Monlezun
authors.affiliation: Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA 70112 (TLM, DM, AJG, EJ, SMS); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (KCA, AKB); Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE) (KCA); Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC) (KCA); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (TMB).
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: George
authors.affiliation: Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA 70112 (TLM, DM, AJG, EJ, SMS); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (KCA, AKB); Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE) (KCA); Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC) (KCA); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (TMB).
authors.forename: Erica
authors.initials: E
authors.lastname: Jones
authors.affiliation: Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA 70112 (TLM, DM, AJG, EJ, SMS); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (KCA, AKB); Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE) (KCA); Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC) (KCA); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (TMB).
authors.forename: T Mark
authors.initials: TM
authors.lastname: Beasley
authors.affiliation: Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA 70112 (TLM, DM, AJG, EJ, SMS); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (KCA, AKB); Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE) (KCA); Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC) (KCA); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (TMB).
authors.forename: Sheryl
authors.initials: S
authors.lastname: Martin-Schild
keywords: in-hospital mortality; ischemic stroke; myocardial infarction