The risk of ischemic stroke after an acute myocardial infarction in diabetic subjects

• Purpose: The incidence, any trend over time and predictors ofischemic stroke after an Acute Myocardial Infarction (AMI) inpatients with diabetes mellitus are unknown.Methods: Data for 173233 unselected AMI patients, including 33503diabetic subjects, was taken from the Swedish Register of Informationand Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA) registry during 1998-2008. Ischemic stroke events were recorded during one year of follow-up.Results: Diabetic subjects more often had a history of cardiovascular disease, received less reperfusion therapy and were treated with Acetylsalicylic Acid (ASA), P2Y12-inhibitors and statins to a lesser extent than nondiabetic subjects. However, the use of evidence basedtherapies increased markedly in both groups during the study period.The incidence of ischemic stroke during the first year after the AMI decreased from 7.1 to 4.7% and from 4.2 to 3.7% in diabetic and nondiabetic subjects, respectively. The risk reduction was significantly larger in the diabetic subgroup. Reperfusion therapy, ASA, P2Y12-inhibitors and statins were independently associated with the reduced stroke risk.Conclusion: Ischemic stroke is not an uncommon complication afteran AMI in diabetic subjects but the risk of stroke has markedly decreased during recent years. The increased use of evidence basedtherapies importantly contributes to this risk reduction, particularly indiabetic subjects, but there is still room for improvement.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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