The Association of Ischemic Stroke after Myocardial Infarction in Bangladesh

Abstract

Background: While most of the complications from a myocardial infarction can be adequately managed, thus leading to reduced mortality, stroke following a myocardial infarction remains a challenge even today, and can lead to potentially devastating complications. Objective: In this study our main goal is to evaluate the association of ischemic stroke after myocardial infarction.
Method: This cross-sectional study was carried out at tertiary medical hospital. A total of 100 patients who approximately 31- to 74-year-old inhabitants, case subjects with a stroke within 1 month after an MI were included in the study. Where during evaluation, patients who had STEMI without Stroke were included in group A, n=50, and patients who had STEMI with Stroke were included in group B, n=50. Results: During the study, most of the patients belong to >61age group, 44% and 60% were male. patients who developed stroke during their hospitalization were more likely to have atrial fibrillation (18% vs 12%), chronic or acute heart failure (65% vs 60%), chronic renal failure (11% vs 5%), prior history of cerebrovascular accident (CVA) (9% vs 5%), diabetes mellitus (35% vs 23%), carotid artery (7% vs 4%) and aortic artery disease(7% vs 5%), CABG during hospitalization (10% vs 7%), and use of mechanical circulatory support (18% vs 9%), compared to those with no ischemic stroke. Besides this, Compared to patients without strokes, those with ischemic stroke were more likely to have higher in-hospital mortality (27% Vs 7%, p < 0.001) in univariate analysis and multivariate analyses and more likely to have higher in-hospital complications that eventually lead to increase mortality. Moreover, apart from age, having atrial Fibrillation, diabetes, history of CVA, heart failure, carotid disease and chronic renal failure were significantly associated with ischemic stroke in patients. Conclusion: The incidence of ischemic stroke following STEMI in the Bangladesh is getting higher over the study period, with increase of in-hospital mortality.