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Stroke risk rises shortly after an acute coronary syndrome
Monday, 29 November 1999 19:00 | 
| Radiology News - Radiology Articles |
Following an acute coronary syndrome, the risk of stroke in the next 30 days may be under-recognized, researchers report in the January issue of Arteriosclerosis, Thrombosis, and Vascular Biology.
Following an acute coronary syndrome, the risk of stroke in the next 30 days may be under-recognized. "Acute coronary syndromes not only carry a high early risk of recurrent cardiac events but also have a high early risk of stroke," researchers report in the January issue of Arteriosclerosis, Thrombosis, and Vascular Biology.
"The risk of stroke in the month after an acute coronary syndrome is up to ten times higher (two to three per cent) than the one-month risk of stroke among patients with stable angina or remote myocardial infarction," Dr. Scott Kinlay, of Brigham and Women's Hospital in Boston, and colleagues report.
The stroke risk early after an acute coronary syndrome is related to the intensity of the inflammation following a cardiac event and the extent of heart damage. However, immediate treatment with high-dose atorvastatin appears to eliminate the risk associated with elevated markers of inflammation, the researchers report.
Dr. Kinlay's group used data from the MIRACL study, a randomized trial of atorvastatin versus placebo in acute coronary syndromes, to examine the role of inflammation on the early risk of stroke after an acute coronary syndrome. They also assessed the effect of statin therapy. Baseline markers of inflammation were compared with the stroke incidence in 2926 patients.
The stroke was significantly related to higher concentrations of C-reactive protein (p = 0.003), serum amyloid A (p = 0.03), and IL-6 (p = 0.004) in the placebo group only, according to the authors. In addition, there was a graded increase in stroke risk across quartiles of inflammatory markers in patients.
The findings suggest that stroke was prevented by reducing inflammation in the arteries in the brain or the carotid or vertebral arteries in the neck, Dr. Kinlay said in an interview with Reuters Health.
"The key message is that intensive cholesterol-lowering with a high-dose statin soon after a heart attack not only prevents repeat heart problems, but it also prevents stroke, probably by having similar effects on dampening the inflammation in arteries that supply the brain as well as those that supply the heart.
"The risk of stroke in the month after an acute coronary syndrome is up to ten times higher (two to three per cent) than the one-month risk of stroke among patients with stable angina or remote myocardial infarction," Dr. Scott Kinlay, of Brigham and Women's Hospital in Boston, and colleagues report.
The stroke risk early after an acute coronary syndrome is related to the intensity of the inflammation following a cardiac event and the extent of heart damage. However, immediate treatment with high-dose atorvastatin appears to eliminate the risk associated with elevated markers of inflammation, the researchers report.
Dr. Kinlay's group used data from the MIRACL study, a randomized trial of atorvastatin versus placebo in acute coronary syndromes, to examine the role of inflammation on the early risk of stroke after an acute coronary syndrome. They also assessed the effect of statin therapy. Baseline markers of inflammation were compared with the stroke incidence in 2926 patients.
The stroke was significantly related to higher concentrations of C-reactive protein (p = 0.003), serum amyloid A (p = 0.03), and IL-6 (p = 0.004) in the placebo group only, according to the authors. In addition, there was a graded increase in stroke risk across quartiles of inflammatory markers in patients.
The findings suggest that stroke was prevented by reducing inflammation in the arteries in the brain or the carotid or vertebral arteries in the neck, Dr. Kinlay said in an interview with Reuters Health.
"The key message is that intensive cholesterol-lowering with a high-dose statin soon after a heart attack not only prevents repeat heart problems, but it also prevents stroke, probably by having similar effects on dampening the inflammation in arteries that supply the brain as well as those that supply the heart.
