title: Patient characteristics and comorbidities associated with cerebrovascular accident following acute myocardial infarction in the United States.
abstract: BACKGROUND
  Although cerebrovascular accident (CVA) is a relatively infrequent complication of acute myocardial infarction (AMI), the occurrence of CVA in patients with AMI is associated with increased morbidity and mortality. We wanted to assess post-AMI CVA rate in the United States and identify the associated patient characteristics, comorbidities, type of AMI, and utilization of invasive procedures.
  
  
  METHODS
  This is an observational study from the Nationwide Inpatient Sample, 2006-2008. Using multivariate regression models, we assessed predictive risk factors for post-AMI CVA among patients admitted for AMI.
  
  
  RESULTS
  Among the 1,924,413 patients admitted for AMI, the overall rate of CVA was 2% (ischemic stroke: 1.47%, transient ischemic attack [TIA]: 0.35% and hemorrhagic stroke: 0.21%). In this sample of AMI patient, higher incidence of CVA was associated with: CHF (adjusted odds ratio [AOR] 1.71; 95% confidence interval [CI], 1.58-1.84,), age over 65 AOR, 1.65; 95% CI, 1.60-1.70, alcohol abuse AOR, 1.60; 95% CI, 1.49-1.73, cocaine use AOR, 1.48; 95% CI, 1.29-1.70, atrial fibrillation AOR, 1.43; 95% CI, 1.39-1.46, Black race AOR, 1.35; 95% CI, 1.30-1.40, female gender AOR, 1.32; 95% CI, 1.29-1.35, peripheral vascular disease [PVD] AOR, 1.26; 95% CI, 1.22-1.30, coronary artery bypass graft (CABG) AOR, 1.22; 95% CI, 1.17-1.27, P<0.0001, STEMI AOR, 1.17; 95% CI, 1.14-1.20 and teaching hospitals AOR, 1.09; 95% CI, 1.06-1.12.
  
  
  CONCLUSIONS
  Female gender, older age (age≥65), black ethnicity, comorbidities including CHF, PVD, atrial fibrillation as well as STEMI and undergoing CABG were associated with the highest risk of CVA post-AMI.
authors.affiliation: Department of Neurology, University of California, Irvine, CA, USA.
authors.forename: Nassim
authors.initials: N
authors.lastname: Naderi
authors.affiliation: Department of Surgery, University of California, Irvine, CA, USA.
authors.forename: Hossein
authors.initials: H
authors.lastname: Masoomi
authors.affiliation: Department of Neurology, University of California, Irvine, CA, USA.
authors.forename: Tahseen
authors.initials: T
authors.lastname: Mozaffar
authors.affiliation: Department of Medicine, Cardiology division, University of California, Irvine, CA, USA. Electronic address: smalik@uci.edu.
authors.forename: Shaista
authors.initials: S
authors.lastname: Malik
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology*; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: Acute myocardial infarction; Cerebrovascular accident; Stroke; Transient ischemic attack