title: Modeling of in hospital mortality determinants in myocardial infarction patients, with and without stroke: A national study in Iran.
abstract: BACKGROUND
  The data and determinants of mortality due to stroke in myocardial infarction (MI) patients are unknown. This study was conducted to evaluate the differences in risk factors for hospital mortality among MI patients with and without stroke history.
  
  
  METHODS
  This study was a retrospective, cohort study; 20,750 new patients with MI from April, 2012 to March, 2013 were followed up and their data were analyzed according to having or not having the stroke history. Stroke and MI were defined based on the World Health Organization's definition. The data were analyzed by logistic regression in STATA software.
  
  
  RESULTS
  Of the 20,750 studied patients, 4293 had stroke history. The prevalence of stroke in the studied population was derived 20.96% (confidence interval [CI] 95%: 20.13-21.24). Of the patients, 2537 (59.1%) had ST-elevation MI (STEMI). Mortality ratio in patients with and without stroke was obtained 18.8% and 10.3%, respectively. The prevalence of risk factors in MI patients with and without a stroke is various. The adjusted odds ratio of mortality in patients with stroke history was derived 7.02 (95% CI: 5.42-9) for chest pain resistant to treatment, 2.39 (95% CI: 1.97-2.9) for STEMI, 3.02 (95% CI: 2.5-3.64) for lack of thrombolytic therapy, 2.2 (95% CI: 1.66-2.91) for heart failure, and 2.17 (95% CI: 1.6-2.9) for ventricular tachycardia.
  
  
  CONCLUSIONS
  With regards to the factors associated with mortality in this study, it is particularly necessary to control the mortality in MI patients with stroke history. More emphasis should be placed on the MI patients with the previous stroke over those without in the interventions developed for prevention and treatment, and for the prevention of avoidable mortalities.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Health, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmadi
authors.affiliation: Department of Cardiology, School of Medicine, Modeling in Health Research Center, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran.
authors.forename: Arsalan
authors.initials: A
authors.lastname: Khaledifar
authors.affiliation: Department of Epidemiology, School of Public Health, Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Koorosh
authors.initials: K
authors.lastname: Etemad
keywords: Mortality; myocardial infarction; risk factor; stroke