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Heart Disease Risk Increases after Stroke

Posted on: Thursday, 23 March 2006, 18:45 CST

NEW YORK (Reuters Health) - After a first stroke, patients are nearly twice as likely to die from heart disease than from another stroke, according to a study published in the medical journal Neurology. However, in the long-term, they are more likely to have another non-fatal stroke than to have a cardiac event.

"Few population-based studies with long-term follow-up have compared risk of recurrent stroke and cardiac events after first ischemic stroke," Dr. M. S. V. Elkind and colleagues from Columbia University, New York, write. "The relative risk of these two outcomes may inform treatment decisions."

The researchers followed 655 ischemic stroke patients enrolled in the population-based Northern Manhattan Study for recurrent stroke, heart attack and death. Ischemic stroke, the most common type, occurs when oxygen to the brain is blocked, usually by a blood clot, causing "ischemia," or tissue death. Hemorrhagic strokes are caused by bleeding in the brain, usually from a ruptured blood vessel.

The team defined fatal cardiac events as: death from a heart attack, death from congestive heart failure, sudden death caused by erratic contractions of the heart (arrhythmia), and cardiopulmonary arrest. The average patient age was 69.7 years.

After five years, the risk of recurrent stroke was more than twice the risk of having a cardiac event (18.3 versus 8.6 percent), Elkind's team reports. The risk of having a non-fatal stroke was 14.8 percent, about twice as high as having a fatal cardiac event (6.4 percent) and four times higher than the risk of having a fatal stroke (3.7 percent).

The researchers also found that the five-year risk of having a fatal cardiac event was 6.4 percent compared with 3.7 percent for having a fatal stroke.

SOURCE: Neurology, March 2006.

Source: REUTERS

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