Abstract 1937: Comparison in Occurrence, Clinical Profile, and Mortality of Patients with Acute Myocardial Infarction and Stroke, Alone and in Combination (A Statewide Report)
Background. Acute myocardial infarction (AMI) and stroke (CVA) are complications of atherosclerosis which account for a high proportion of mortality and disability in the US. However, there are limited data comparing the occurrence, characteristics, and outcomes of these events alone and in combination at the population level.
Methods. Using the Myocardial Infarction Data Acquisition System (MIDAS), a New Jersey statewide database, we studied all hospitalized myocardial infarctions and strokes in 2004. Results. There were 21,432 hospitalizations for AMI, 14,049 hospitalizations for CVA, and in 657 instances, both AMI and CVA occurred in the same hospitalization. The rates per 100,000 population for AMI were 297 for men and 200 for women, for CVA were 151 for men and 173 for women, and for both diagnoses were 6.43 for men and 8.70 for women. Compared to patients with AMI, those with CVA were older (73.3 vs. 69.2 years; P<0.0001), more likely to be women (54% vs. 42%; P=0.01), black (16% vs. 8%), and to have hypertension (74% vs. 60%; P<0.0001), and less likely to have renal disease (4.2% vs. 9.6%; P<0.0001). They also had a longer mean length of hospital stay (8.2 vs. 7.2 days; P<0.0001) and higher in-hospital mortality (9.61% vs. 7.11%; P<0.0001). Patients with both diagnoses in the same hospitalization had a median age of 74 years, were 59% women, and 13% black. More of these patients had renal disease (15.7%) but fewer had hypertension (52%). Their mean hospital stay was longer (12.9 days). Patients with both AMI and CVA had significantly higher in-hospital mortality than those with either diagnosis alone (29.53%; P<0.0001).
Conclusions. Compared to hospitalized MI patients, those with CVA were older, more likely to be women, have hypertension, a longer hospital stay and higher in-hospital mortality. Patients with both events in the same hospitalization had 3– 4 times the in-hospital mortality of either diagnosis alone, and were more likely to have renal disease, but surprisingly less likely to have hypertension.