Clinical characteristics and mid-term outcomes of acute myocardial infarction patients with prior cerebrovascular disease in an Asian population

Lessons from the Korea Acute Myocardial Infarction Registry

Yong Jian Li, Seung-Woon Rha, Kang Yin Chen, Zhe Jin, Yoshiyasu Minami, Lin Wang, Qun Dang, Kanhaiya L. Poddar, Sureshkumar Ramasamy, Ji Young Park, Dong Joo Oh, Myung Ho Jeong

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

1. The aim of the present study was to evaluated the impact of prior cerebrovascular disease (CVD) on the clinical characteristics and mid-term clinical outcomes of patients with acute myocardial infarction (AMI) in the era of drug-eluting stents. 2. Data from 12 914 patients with acute myocardial infarction who were enrolled in the Korea Acute Myocardial Infarction Registry were analysed retrospectively from November 2005 to December 2007. Prior CVD was defined as having had one or more events of ischaemic or haemorrhagic stroke or a transient ischaemic attack. 3. Of the 12 914 patients reviewed, 906 (7.0%) were found to have had prior CVD. Patients with CVD were older, were more likely to be women and were more likely to have hypertension and diabetes than those without CVD. Patients with prior CVD presented more often with non-ST-segment elevation myocardial infarction and higher Killip class than those without CVD. Furthermore, patients with CVD received less percutaneous coronary intervention (PCI) or thrombolysis compared with those without CVD. Although intensive medical therapy was equal in both groups, clinical outcomes at 8 months showed that patients with CVD had a higher incidence of cardiac death (adjusted odds ratio (OR) 1.42; 95% confidence interval (CI) 1.14-1.76; P = 0.002) and total death (adjusted OR 1.50; 95% CI 1.25-1.81; P < 0.001) than those without CVD. 4. In conclusion, patients with prior CVD presented with worse clinical characteristics on admission and were less likely to receive PCI or thrombolysis than those without CVD. Given the poorer mid-term clinical outcomes, more intensive and aggressive management shouldis recommended for patients with prior CVD to improve their long-term clinical outcome.

Original languageEnglish
Pages (from-to)581-586
Number of pages6
JournalClinical and Experimental Pharmacology and Physiology
Volume37
Issue number5-6
DOIs
Publication statusPublished - 2010 May 1

Fingerprint

Cerebrovascular Disorders
Korea
Registries
Myocardial Infarction
Population
Percutaneous Coronary Intervention
Odds Ratio
Confidence Intervals
Drug-Eluting Stents
Transient Ischemic Attack

Keywords

  • Acute myocardial infarction
  • Drug-eluting stent
  • Percutaneous coronary intervention
  • Prior cerebrovascular disease

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)
  • Pharmacology

Cite this

Clinical characteristics and mid-term outcomes of acute myocardial infarction patients with prior cerebrovascular disease in an Asian population : Lessons from the Korea Acute Myocardial Infarction Registry. / Li, Yong Jian; Rha, Seung-Woon; Chen, Kang Yin; Jin, Zhe; Minami, Yoshiyasu; Wang, Lin; Dang, Qun; Poddar, Kanhaiya L.; Ramasamy, Sureshkumar; Park, Ji Young; Oh, Dong Joo; Jeong, Myung Ho.

In: Clinical and Experimental Pharmacology and Physiology, Vol. 37, No. 5-6, 01.05.2010, p. 581-586.

Research output: Contribution to journalArticle

Li, Yong Jian ; Rha, Seung-Woon ; Chen, Kang Yin ; Jin, Zhe ; Minami, Yoshiyasu ; Wang, Lin ; Dang, Qun ; Poddar, Kanhaiya L. ; Ramasamy, Sureshkumar ; Park, Ji Young ; Oh, Dong Joo ; Jeong, Myung Ho. / Clinical characteristics and mid-term outcomes of acute myocardial infarction patients with prior cerebrovascular disease in an Asian population : Lessons from the Korea Acute Myocardial Infarction Registry. In: Clinical and Experimental Pharmacology and Physiology. 2010 ; Vol. 37, No. 5-6. pp. 581-586.
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abstract = "1. The aim of the present study was to evaluated the impact of prior cerebrovascular disease (CVD) on the clinical characteristics and mid-term clinical outcomes of patients with acute myocardial infarction (AMI) in the era of drug-eluting stents. 2. Data from 12 914 patients with acute myocardial infarction who were enrolled in the Korea Acute Myocardial Infarction Registry were analysed retrospectively from November 2005 to December 2007. Prior CVD was defined as having had one or more events of ischaemic or haemorrhagic stroke or a transient ischaemic attack. 3. Of the 12 914 patients reviewed, 906 (7.0{\%}) were found to have had prior CVD. Patients with CVD were older, were more likely to be women and were more likely to have hypertension and diabetes than those without CVD. Patients with prior CVD presented more often with non-ST-segment elevation myocardial infarction and higher Killip class than those without CVD. Furthermore, patients with CVD received less percutaneous coronary intervention (PCI) or thrombolysis compared with those without CVD. Although intensive medical therapy was equal in both groups, clinical outcomes at 8 months showed that patients with CVD had a higher incidence of cardiac death (adjusted odds ratio (OR) 1.42; 95{\%} confidence interval (CI) 1.14-1.76; P = 0.002) and total death (adjusted OR 1.50; 95{\%} CI 1.25-1.81; P < 0.001) than those without CVD. 4. In conclusion, patients with prior CVD presented with worse clinical characteristics on admission and were less likely to receive PCI or thrombolysis than those without CVD. Given the poorer mid-term clinical outcomes, more intensive and aggressive management shouldis recommended for patients with prior CVD to improve their long-term clinical outcome.",
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AU - Chen, Kang Yin

AU - Jin, Zhe

AU - Minami, Yoshiyasu

AU - Wang, Lin

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AU - Poddar, Kanhaiya L.

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KW - Acute myocardial infarction

KW - Drug-eluting stent

KW - Percutaneous coronary intervention

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