Your browser doesn't support javascript.
loading
Incidence and Outcomes of Cardiocerebral Infarction: A Cohort Study of 2 National Population-Based Registries.
Ho, Jamie Sin-Ying; Zheng, Huili; Tan, Benjamin Yong-Qiang; Ho, Andrew Fu-Wah; Foo, David; Foo, Ling-Li; Lim, Patrick Zhan-Yun; Liew, Boon Wah; Ahmad, Aftab; Chan, Bernard P L; Chang, Hui Meng; Kong, Keng He; Young, Sherry H; Tang, Kok Foo; Chua, Terrance; Hausenloy, Derek J; Yeo, Tiong-Cheng; Tan, Huay-Cheem; Yip, James W L; Chai, Ping; Venketasubramanian, Narayanaswamy; Chan, Mark Yan-Yee; Yeo, Leonard Leong-Litt; Sia, Ching-Hui.
Afiliação
  • Ho JS; Department of Cardiology, National University Heart Centre Singapore (J.S.-Y.H., T.-C.Y., H.-C.T., J.W.L.Y., P.C., M.Y.-Y.C., C.-H.S.).
  • Zheng H; Clinical Research Unit, Khoo Teck Puat Hospital, Singapore (H.Z.).
  • Tan BY; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore (B.Y.-Q.T., D.J.H., T.-C.Y., H.-C.T., J.W.L.Y., P.C., M.Y.-Y.C., L.L.-L.Y., C.-H.S.).
  • Ho AF; Division of Neurology, Department of Medicine, National University Health System, Singapore. (B.Y.-Q.T., B.P.L.C., L.L.-L.Y.).
  • Foo D; Department of Emergency Medicine, Singapore General Hospital, Duke-National University of Singapore Medical School. (A.F.-W.H.).
  • Foo LL; Pre-Hospital and Emergency Research Centre, Duke-National University of Singapore Medical School. (A.F.-W.H.).
  • Lim PZ; Tan Tock Seng Hospital, Singapore (D.F.).
  • Liew BW; Health Promotion Board, National Registry of Diseases Office, Singapore (L.-L.F.).
  • Ahmad A; Department of Cardiology, Khoo Teck Puat Hospital, Singapore (P.Z.-Y.L.).
  • Chan BPL; Department of Cardiology, Changi General Hospital, Singapore (B.W.L.).
  • Chang HM; Department of Neurology, Ng Teng Fong General Hospital, National University Health System, Singapore. (A.A.).
  • Kong KH; Division of Neurology, Department of Medicine, National University Health System, Singapore. (B.Y.-Q.T., B.P.L.C., L.L.-L.Y.).
  • Young SH; Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute (H.M.C.).
  • Tang KF; Department of Neurology, National Neuroscience Institute, Neurology, Tan Tock Seng Hospital, Singapore (K.H.K.).
  • Chua T; Department of Rehabilitation Medicine, Changi General Hospital, Singapore (S.H.Y.).
  • Hausenloy DJ; Tang Neurology and Medical Clinic, Mount Elizabeth Medical Centre, Singapore (K.F.T.).
  • Yeo TC; Department of Cardiology, National Heart Centre Singapore. (T.C.).
  • Tan HC; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore (B.Y.-Q.T., D.J.H., T.-C.Y., H.-C.T., J.W.L.Y., P.C., M.Y.-Y.C., L.L.-L.Y., C.-H.S.).
  • Yip JWL; Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School. (D.J.H.).
  • Chai P; National Heart Research Institute Singapore, National Heart Centre Singapore. (D.J.H.).
  • Venketasubramanian N; The Hatter Cardiovascular Institute, University College London, United Kingdom (D.J.H.).
  • Chan MY; Department of Cardiology, National University Heart Centre Singapore (J.S.-Y.H., T.-C.Y., H.-C.T., J.W.L.Y., P.C., M.Y.-Y.C., C.-H.S.).
  • Yeo LL; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore (B.Y.-Q.T., D.J.H., T.-C.Y., H.-C.T., J.W.L.Y., P.C., M.Y.-Y.C., L.L.-L.Y., C.-H.S.).
  • Sia CH; Department of Cardiology, National University Heart Centre Singapore (J.S.-Y.H., T.-C.Y., H.-C.T., J.W.L.Y., P.C., M.Y.-Y.C., C.-H.S.).
Stroke ; 2024 Jul 31.
Article em En | MEDLINE | ID: mdl-39082144
ABSTRACT

BACKGROUND:

Cardiocerebral infarction (CCI), which is concomitant with acute myocardial infarction (AMI) and acute ischemic stroke (AIS), is a rare but severe presentation. However, there are few data on CCI, and the treatment options are uncertain. We investigated the characteristics and outcomes of CCI compared with AMI or AIS alone.

METHODS:

We performed a retrospective cohort study of 120 531 patients with AMI and AIS from the national stroke and AMI registries in Singapore. Patients were categorized into AMI only, AIS only, synchronous CCI (same-day), and metachronous CCI (within 1 week). The primary outcome was all-cause mortality, and the secondary outcome was cardiovascular mortality. The mortality risks were compared using Cox regression. Multivariable models were adjusted for baseline demographics, clinical variables, and treatment for AMI or AIS.

RESULTS:

Of 127 919 patients identified, 120 531 (94.2%) were included; 74 219 (61.6%) patients had AMI only, 44 721 (37.1%) had AIS only, 625 (0.5%) had synchronous CCI, and 966 (0.8%) had metachronous CCI. The mean age was 67.7 (SD, 14.0) years. Synchronous and metachronous CCI had a higher risk of 30-day mortality (synchronous adjusted HR [aHR], 2.41 [95% CI, 1.77-3.28]; metachronous aHR, 2.80 [95% CI, 2.11-3.73]) than AMI only and AIS only (synchronous aHR, 2.90 [95% CI, 1.87-4.51]; metachronous aHR, 4.36 [95% CI, 3.03-6.27]). The risk of cardiovascular mortality was higher in synchronous and metachronous CCI than AMI (synchronous aHR, 3.03 [95% CI, 2.15-4.28]; metachronous aHR, 3.41 [95% CI, 2.50-4.65]) or AIS only (synchronous aHR, 2.58 [95% CI, 1.52-4.36]; metachronous aHR, 4.52 [95% CI, 2.95-6.92]). In synchronous CCI, AMI was less likely to be managed with PCI and secondary prevention medications (P<0.001) compared with AMI only.

CONCLUSIONS:

Synchronous CCI occurred in 1 in 200 cases of AIS and AMI. Synchronous and metachronous CCI had higher mortality than AMI or AIS alone.
Palavras-chave
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Stroke Ano de publicação: 2024 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Stroke Ano de publicação: 2024 Tipo de documento: Article