Elderly patients have a high risk of stroke within six months of a heart attack

New Haven, Conn. Twenty percent of older patients who have suffered a heart attack have a one in 25 chance of being hospitalized for a stroke within six months of discharge from the hospital, according to research at Yale.

The study provides what is believed to be the most accurate estimates of stroke after heart attack among elderly patients. This is because it includes the largest and most geographically diverse sample of older heart attack patients who have not been excluded from the study based on other illnesses or older age.

"The importance of stroke after myocardial infarction (MI) has been underappreciated, especially among older persons," said Judith Lichtman, assistant professor in the Department of Epidemiology and Public Health at Yale School of Medicine. "Our results demonstrate that stroke after MI is much more common than previously reported."

Lichtman, whose study is published in the March issue of the journal Circulation, said the rate of stroke following a heart attack has frequently been based on clinical studies that often exclude older patients and those with more significant medical problems. Yet, among patients hospitalized with a stroke, 77 percent are 65 years of age or older and half are older than 75 years of age.

"With improved survival after MI and an increasing number of elderly people in the population, stroke after MI will be increasingly common problem in the coming decades," she said.

Lichtman and her co-authors analyzed the data from more than 111,000 elderly patients included in the Cooperative Cardiovascular Project, which is a large, geographically diverse population-based group of patients hospitalized with acute myocardial infarction (AMI).

"Overall, 2.5 percent were admitted with an ischemic stroke within six months of discharge," Lichtman said.

She said older patients, African American patients, and patients with any frailty are at increased risk for a stroke af

Contact: Jacqueline Weaver
Yale University

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