Long-term risk of myocardial infarction after a first-ever stroke

Purpose. To examine the incidence of myocardial infarction during the first three years after a first-ever stroke. Material and methods. Both Kaunas community-based stroke register and ischemic heart disease register served at the primary source of data. The methods used for data collection were those applied by the World Healt Organisation (WHO) for the WHO MONICA project. During 1986 to 1994, 2531 patients aged 25 to 64 years with a first-ever stroke were registered and followed-up for three years for the information on the firstever acute myocardial infarction or death from ischemic heart disease. Actuarial life tables were used to analyze risk of myocardial infarction. Results. During the study period, 58 patients with the first-ever acute myocardial infarction that occurred among the first-ever stroke survivors were identified. Fifty-three first-ever ischemic stroke survivors (39 (73.6%) men and 14 (26.4%) women, (p=0.07)) experienced their first-ever myocardial infarction. The cumulative risk of suffering an acute myocardial infarction was 3.5% (95% confidence interval 2.6 to 4.4%) by 3 years: in male ischemic stroke survivors this risk accounted for 4.3% (95% confidence interval 3.0 to 5.6%) and in female \u96 2.3% (95% confidence interval 1.1 to 3.5%). The risk was the highest one early after ictus in the ischemic stroke survivors: 0.5% (95% confidence interval 0.2 to 0.8%) by 3 months (men \u96 0.7% (95% confidence interval 0.2 to 1.2%), women \u96 0.3% (95% confidence interval 0.0 to 0.7%)). Conclusion. The risk of myocardial infarction is the highest early after the first stroke, although due to relatively small number of cases confidence intervals were too wide to reach a statistical significance