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    Trends (1986 to 1999) in the incidence and outcomes of in-hospital stroke complicating acute myocardial infarction (The Worcester Heart Attack Study)

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    Authors
    Spencer, Frederick A.
    Gore, Joel M.
    Yarzebski, Jorge L.
    Lessard, Darleen M.
    Jackson, Elizabeth A.
    Goldberg, Robert J.
    UMass Chan Affiliations
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2003-08-14
    Keywords
    Aged
    Female
    Hospital Mortality
    *Hospitalization
    Humans
    Male
    Middle Aged
    Myocardial Infarction
    Risk Factors
    Stroke
    Bioinformatics
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1016/S0002-9149(03)00654-4
    Abstract
    Although stroke is an infrequent hospital complication of acute myocardial infarction (AMI), limited contemporary data are available about the incidence and death rates associated with this serious complication. The objective of this population-based study was to examine temporal trends (1986 to 1999) in the risk of stroke and associated hospital outcomes in patients hospitalized with AMI. This was an observational study of 6,325 metropolitan Worcester, Massachusetts, residents hospitalized with validated AMI and without prior stroke at all greater Worcester hospitals during 8 one-year periods between 1986 and 1999. Overall, 1.5% of patients (n = 92) with confirmed AMI developed an acute stroke during their index hospitalization. Decreases, followed by increases, in the risk of acute stroke were observed between 1986 and 1999. The highest risk for stroke was observed in the most recent study year of 1999 (3.0%). Several demographic, medical history, and clinical characteristics were associated with an increased risk of stroke overall and separately in younger and older patients hospitalized with AMI. Patients developing an acute stroke had a significantly increased risk of dying during hospitalization even after controlling for other factors of prognostic importance (adjusted odds ratio 4.26, 95% confidence interval 2.49 to 7.31). The results of this community-wide study provide insights into recent trends in the development of acute stroke after AMI and into the profile of high-risk patients.
    Source
    Am J Cardiol. 2003 Aug 15;92(4):383-8.
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47162
    PubMed ID
    12914866
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    Population and Quantitative Health Sciences Publications

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