title: Effect of coronary artery revascularization on in-hospital outcomes and long-term prognoses in acute myocardial infarction patients with prior ischemic stroke.
abstract: OBJECTIVE
  To investigate whether coronary artery revascularization therapies (CART), including percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), can improve the in-hospital and long-term outcomes for acute myocardial infarction (AMI) patients with prior ischemic stroke (IS).
  
  
  METHODS
  A total of 387 AMI patients with prior IS were enrolled consecutively from January 15, 2005 to December 24, 2011 in this cohort study. All patients were categorized into the CART group (n = 204) or the conservative medications (CM) group (n = 183). In-hospital cardiocerebral events and long-term mortality of the two groups after an average follow-up of 36 months were recorded by Kaplan-Meier survival curves and compared by Logistic regression and the Cox regression model.
  
  
  RESULTS
  The CART patients were younger (66.5 ± 9.7 years vs. 71.7 ± 9.7 years, P < 0.01), had less non-ST segment elevation myocardial infarction (11.8% vs. 20.8%, P = 0.016) and more multiple-vascular coronary lesions (50% vs. 69.4%, P = 0.031). The hospitalization incidence of cardiocerebral events in the CART group was 9.3% while 26.2% in the CM group (P < 0.01). CART significantly reduced the risk of in-hospital cardiocerebral events by 65% [adjusted odds ratio (OR) = 0.35, 95% CI: 0.13-0.92]. By the end of follow-up, 57 cases (41.6%) died in CM group (n = 137) and 24 cases (12.2%) died in CART group (n = 197). Cox regression indicated that CART decreased the long-term mortality by 72% [adjusted hazard ratio (HR) = 0.28, 95% CI: 0.06-0.46], while categorical analysis indicated no significant difference between PCI and CABG.
  
  
  CONCLUSIONS
  CART has a significant effect on improving the in-hospital and long-term prognoses for AMI patients with prior IS.
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Bo-Yu
authors.initials: BY
authors.lastname: Li
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Li
authors.affiliation: School of Nursing, Capital Medical University, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhan-Yun
authors.initials: ZY
authors.lastname: Wei
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Hua
keywords: Acute myocardial infarction; Conservative medications; Coronary artery bypass grafting; Coronary artery revascularization; Ischemic stroke; Percutaneous coronary intervention