The Impact of Myocardial Infarction vs. Pneumonia on Outcome in Acute Ischemic Stroke

• Published in: Journal of cardiovascular disease Vol. 2; no. 1; p. 1
• Main Authors: Mathias, Tiffany L, Albright, Karen C, Boehme, Amelia K, Monlezun, Dominique, George, Alexander J, Jones, Erica, Beasley, T Mark, Martin-Schild, Sheryl
• Format: Journal Article
• Language: English
• Published: United States 01.01.2014
• Subjects: in-hospital mortality; ischemic stroke; myocardial infarction
• ISSN: 2330-4596

The aim of this study was to examine the association between MI and PNA in the setting of acute ischemic stroke and patient outcome. Eligible patients were identified from a prospectively collected stroke registry and included if transthoracic echocardiography (TTE) was performed during their inpatient stay. 426 patients met inclusion criteria (mean age 64, 73% Black, 48% female). Twenty-one patients (4.9%) experienced an MI. Patients who later suffered a MI initially presented with more severe strokes (median NIHSS 7 vs. 5, p=0.014). More patients in the MI group experienced pneumonia (26% vs. 9%, p=0.004). After adjusting for age, baseline glucose and NIHSS, the odds of in-hospital mortality for patients with MI was 3 times that of those without MI (OR 3.2 95% CI 1.1-9.7, p=0.036). When adjustment was made for pneumonia, age, baseline glucose and NIHSS, MI was no longer significantly related to in-hospital mortality (OR 2.5 95% CI 0.8-8.2, p=0.131). In our sample, while MI was significantly associated with in-hospital mortality, this association was attenuated after adjusting for presence of pneumonia. Our findings raise the question as to whether the prevention of pneumonia could improve in-hospital mortality among patients who experience MI in the setting of ischemic stroke.