American Stroke Association International Stroke Conference 2024, abstract WP244
Research Highlights: The risk of a heart attack among adults after a stroke caused by a clot or a stroke plus carotid or vertebral artery dissection was almost double during the first year compared with the risk of heart attack for people who did not suffer a stroke but were hospitalized with medical problems. Medical events included some overlapping symptoms, such as warning stroke, migraine, or transient global amnesia . However, people with carotid artery or vertebral artery dissection but without stroke were not significantly more likely to have a heart attack than those with a warning stroke, migraine, or amnesia. |
Development
The risk of heart attack almost doubles in the first year after a stroke or when combined with a carotid or vertebral artery dissection; However, a tear without a stroke does not appear to increase the risk of heart attack, according to preliminary research presented at the American Stroke Association’s 2024 International Stroke Conference. The meeting was held in Phoenix, February 7-9, and is a premier global meeting for researchers and clinicians dedicated to the science of stroke and brain health.
"Our findings may help clinicians assess and manage cardiovascular risk after these events," said Dr. Liqi Shu, a clinical researcher in neurology at the Warren Alpert School of Medicine at Brown University in Providence, Rhode Island.
Aortic dissection is a tear in the wall of the aorta, and it is known to increase the risk of heart attack. Tears in the walls of the carotid or vertebral arteries , which extend from the aorta and carry blood through the neck to the brain, are called carotid or vertebral artery dissections. These dissections can lead to a stroke, and stroke is known to be associated with a heart attack. Before this study it was unclear whether carotid or vertebral artery dissection itself increases the risk of heart attack.
The researchers analyzed health information from more than 800,000 adults (average age 63; 62% women) hospitalized in New York (between 2011 and 2017) or Florida (between 2011-2019). Patients without a history of recent major trauma to the head or neck were separated into four groups based on diagnosis:
- Acute ischemic stroke
- Cervical artery dissection
- Both
- Reference group of patients with transient ischemic attack known as “warning stroke”, temporary loss of short-term memory (transient global amnesia) or migraine.
After adjusting for heart attack risk factors, the study found:
- Patients who had a carotid or vertebral artery dissection without having a stroke had the same risk of having a heart attack within one year as those in the control group.
- Stroke patients, with or without carotid or vertebral artery dissection, were almost twice as likely to have a heart attack within a year, compared to patients in the control group.
“It used to be just a guess, but now we know that carotid or vertebral artery dissection that doesn’t cause a stroke doesn’t increase the risk of a heart attack, and it makes sense for doctors to focus predominantly on stroke prevention in this subgroup of patients,” Shu said.
Background of the study:
Participants with a recent history of severe head or neck trauma were excluded . Head or neck trauma can lead to traumatic carotid dissection, which is different from this study’s focus on spontaneous dissection.
The analysis controlled for several heart attack risk factors , including age, type 1 or type 2 diabetes, heart failure, coronary artery disease, high cholesterol and high blood pressure.
Nearly 20,000 of the participants had a heart attack within a year of their initial hospitalization, and heart attack risk was compared between diagnosis groups.
Among the study group of 823,634 participants, 65.4% were white, 16.2% were black or African American, and 12.2% were Hispanic or Latino adults.
While this study is based on hospitalization data only in New York and Florida, it is important to note that these states together represent a substantial portion of the US population, accounting for more than 10% of the total. These two states also offer good representation of diverse demographic groups, reinforcing the findings. However, caution should still be used when generalizing these results to people living in other geographic areas. Additionally, this retrospective analysis (looking back in time to analyze the data) may not have taken into account all the factors that influence heart attack risk, such as medication use, that were not included in the database. of data.
According to the American Heart Association’s Heart Disease and Stroke Statistics 2024 Update, strokes accounted for about 1 in 21 deaths in the United States in 2021.
Co-authors, disclosures, and funding sources are listed in the abstract.
Statements and conclusions from studies presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the policy or position of the Association. The Association does not represent or guarantee its accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed but are selected by independent review panels and are considered based on their potential to contribute to the diversity of scientific issues and viewpoints discussed at the meeting. . The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.
