Clinical characteristics analysis of elderly patients with acute myocardial infarction complicated with ischemic stroke
10.3969/j.issn.1009-0126.2024.12.012
- VernacularTitle:老年急性心肌梗死合并缺血性脑卒中患者的临床特征分析
- Author:
Junxian SONG
1
;
Yuxia CUI
1
;
Meng WANG
1
;
Jiangtian CHEN
1
;
Hong CHEN
1
Author Information
1. 100044 北京大学人民医院心血管内科
- Publication Type:Journal Article
- Keywords:
myocardial infarction;
stroke;
coronary artery disease;
intracranial arterial diseases
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(12):1438-1442
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics of elderly patients with acute myo-cardial infarction(AMI)complicated with ischemic stroke and provide reference for the formula-tion of more precise prevention and treatment strategies.Methods A retrospective study was con-ducted on 439 consecutive AMI patients admitted to our department from January 2018 to Decem-ber 2019.They were divided into ischemic stroke group(n=55)and non-ischemic stroke group(n=384)based on having concomitant ischemic stroke or not.For the 114 patients who completed head CT angiography,they were assigned into ischemic stroke patients(n=27)and non-ischemic stroke patients(n=87).The clinical characteristics and intracranial arterial lesions were analyzed in the patients.Total score of intracranial artery calcification was used to evaluate the level of in-tracranial artery calcification and the degree of atherosclerosis.Results The ischemic stroke group had significantly larger proportions of concomitant hypertension,diabetes and renal dysfunction,pre-admission usage of aspirin/clopidogrel and statin,higher levels of glycosylated hemoglobin(HbA1c)and B-type brain natriuretic peptide,more 3-vessel lesions and elevated Gensini score,but decreased hemoglobin level,platelet count and estimated glomerular filtration rate when com-pared with the non-ischemic stroke patients(P＜0.05,P＜0.01).The proportions of intracranial artery calcification,severe calcification,intracranial artery carotid calcification,and intracranial artery stenosis ≥50％were obviously higher in the ischemic stroke patients than the non-ische-mic stroke patients(92.6％vs 78.2％,P=0.041;40.7％vs 21.8％,P=0.037;81.5％vs 62.1％,P=0.039;55.6％vs 35.6％,P=0.042).Binary logistic regression analysis showed that diabetes was an independent risk factor for ischemic stroke in the elderly AMI patients(OR=2.187,95％CI:1.205-3.970,P=0.010).Conclusion The elderly AMI patients complicated with ischemic stroke have more comorbidities,and severer disease condition,coronary artery disease and in-tracranial artery disease.In addition,coexistence of diabetes significantly increases the risk of is-chemic stroke in elderly AMI patients.
