Long-term risk of stroke in myocardial infarction survivors: Thirty-year population-based cohort study

Jens Sundbøll, Erzsébet Horváth-Puhó, Morten Schmidt, Lars Pedersen, Victor W. Henderson, Hans Erik Bøtker, Henrik Toft Sørensen

Research output: Article

2 Citations (Scopus)

Abstract

Background and Purpose - Improved survival after myocardial infarction (MI) has increased the number of patients at risk of post-MI stroke. We examined risks of ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in patients with MI compared with the general population. Methods - We conducted a nationwide population-based cohort study using Danish medical registries. During 1980 to 2009, we identified all patients with a first-time inpatient diagnosis of MI and formed a sex- and age-matched comparison cohort. We computed cumulative stroke risks and adjusted stroke rate ratios with 95% confidence intervals (CIs). Results - We identified 258 806 patients with an MI and 1 244 773 individuals from the general population. For patients with MI, the cumulative stroke risks after 1 to 30 years were 12.6% for ischemic stroke, 1.2% for ICH, and 0.24% for SAH. During the first 30 days after MI, the adjusted stroke rate ratio was 30-fold increased for ischemic stroke (31.9; 95% CI, 28.4-35.8), 20-fold for ICH (21.8; 95% CI, 16.6-28.5), and 15-fold for SAH (16.6; 95% CI, 8.7-32.0). The adjusted stroke rate ratio remained increased during 31 to 365 days (3-fold for ischemic stroke, 2-fold for ICH, and 1.5-fold for SAH). During the ensuing 1 to 30 years, the risks remained increased for ischemic stroke (1.6; 95% CI, 1.6-1.6) but decreased to near unity for ICH (1.1; 95% CI, 1.0-1.2) and SAH (1.1; 95% CI, 0.94-1.2). Conclusions - MI was a risk factor for all stroke subtypes during the first year of follow-up, but only for ischemic stroke thereafter.

Original languageEnglish
Pages (from-to)1727-1733
Number of pages7
JournalStroke
Volume47
Issue number7
DOIs
Publication statusPublished - júl. 1 2016

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

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  • Cite this

    Sundbøll, J., Horváth-Puhó, E., Schmidt, M., Pedersen, L., Henderson, V. W., Bøtker, H. E., & Sørensen, H. T. (2016). Long-term risk of stroke in myocardial infarction survivors: Thirty-year population-based cohort study. Stroke, 47(7), 1727-1733. https://doi.org/10.1161/STROKEAHA.116.013321