Skip Navigation



European Heart Journal Advance Access published online on June 21, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi352
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
26/20/2114    most recent
ehi352v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Szummer, K. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Szummer, K. E.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received October 22, 2004
Revised February 11, 2005
Accepted April 28, 2005

Clinical research

Heart failure on admission and the risk of stroke following acute myocardial infarction: the VALIANT registry

Karolina E. Szummer 1, Scott D. Solomon 2, Eric J. Velazquez 3, Rakhi Kilaru 3, John McMurray 4, Jean-Lucien Rouleau 5, Kenneth W. Mahaffey 3, Aldo P. Maggioni 6, Robert M. Califf 3, Marc A. Pfeffer 2, Harvey D. White 7*, and on behalf of the VALIANT registry

1 Department of Cardiology, Karolinska University Hospital Huddinge, Stockholm, Sweden
2 Brigham and Women's Hospital, Boston, MA, USA
3 Division of Cardiology, Department of Medicine, Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA
4 University of Glasgow, Glasgow, UK
5 University of Toronto, Ontario, Canada
6 Italian Association of Hospital Cardiologists Research Center, Florence, Italy
7 Green Lane Cardiovascular Service, Auckland City Hospital, Private Bag 92 024, Auckland 1003, New Zealand

* To whom correspondence should be addressed.
Harvey D. White, E-mail: harveyw{at}adhb.govt.nz


  Abstract

Aims We sought to assess the relative contribution of heart failure (HF) on admission for an acute myocardial infarction (MI) to the subsequent in-hospital stroke risk.

Methods and results The VALsartan In Acute myocardial iNfarcTion (VALIANT) registry enrolled 5573 consecutive MI patients at 84 international sites from 1999 to 2001. We calculated odds ratios (ORs) for stroke and adjusted for baseline characteristics, Killip Class, and risk factors for stroke, such as diabetes and prior HF.

In-hospital stroke occurred in 81 (1.5%) patients. HF was present on admission in 38% of patients who developed a stroke and in 24% who did not (P = 0.001). Older age (OR 1.03 increase/year, 95% confidence interval (CI) 1.01-1.04), Killip Class III (OR 1.66, CI 0.86-3.19) or IV (OR 4.85, CI 1.69-13.93), history of hypertension (OR 1.73, CI 1.06-2.82), and history of stroke (OR 1.89, CI 1.06-3.37) were more common in patients who had in-hospital stroke. In-hospital mortality in patients with and without stroke was 27.2 and 6.5%, respectively (P < 0.001).

Conclusion Patients with stroke after MI have a dismal prognosis. The presence of HF on admission for an acute MI increases in-hospital stroke risk. HF treatments may modify the risk of stroke.

Keywords: Stroke; Risk factors; Myocardial infarction.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Postgrad. Med. J.Home page
N U Weir
An update on cardioembolic stroke
Postgrad. Med. J., March 1, 2008; 84(989): 133 - 142.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
U. K. Sampson, M. A. Pfeffer, J. J.V. McMurray, Y. Lokhnygina, H. D. White, S. D. Solomon, and for the Valsartan in Acute Myocardial iNfarcTion (
Predictors of stroke in high-risk patients after acute myocardial infarction: insights from the VALIANT trial
Eur. Heart J., March 2, 2007; 28(6): 685 - 691.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
C. M. Westerhout, A. V. Hernandez, E. W. Steyerberg, H. Bueno, H. White, P. Theroux, D. J. Moliterno, P. W. Armstrong, R. M. Califf, L. C. Wallentin, et al.
Predictors of stroke within 30 days in patients with non-ST-segment elevation acute coronary syndromes
Eur. Heart J., December 2, 2006; 27(24): 2956 - 2961.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.