Stroke, Vol 23, 1250-1256, Copyright © 1992 by American Heart Association
JP Broderick, SJ Phillips, WM O'Fallon, RL Frye and JP Whisnant
BACKGROUND AND PURPOSE: This is a study of cardiac diseases associated with
the 1,382 cases of first cerebral infarction in residents of Rochester,
Minn., during 1960-1984. METHODS: This is a population-based study in
Rochester, Minn., for which the medical record-linkage system was used to
identify cardiac disease among patients with first cerebral infarction.
RESULTS: There were 318 patients (23%) who had at least one major potential
cardiac source of emboli. The proportion of patients with a cardiac source
of emboli was significantly higher among patients older than age 75 years
(29%) than among younger patients (17%). The 30- day stroke recurrence rate
among patients with a cardiac source of emboli (2%) was not significantly
different than that among those without a cardiac source of emboli (2%).
Among patients with a cardiac source of emboli, there was no difference in
the probability of stroke at 30 days and at 90 days for those treated or
not treated with anticoagulants. During the first 30 days after cerebral
infarction, the risk of death in patients with a cardiac source of emboli
(23%) was 14 times that of recurrent stroke. The risk of death at 30 days
in patients without a cardiac source of emboli was 8%. CONCLUSIONS:
Significant independent predictors of death (Cox proportional-hazards
analysis) were age, prior myocardial infarction, atrial fibrillation
present at onset of stroke, congestive heart failure before the stroke, and
an age x congestive heart failure interaction. The only significant
independent predictors of recurrent stroke were cardiac valve disease and
congestive heart failure.
ARTICLES
Relationship of cardiac disease to stroke occurrence, recurrence, and mortality
Department of Neurology, Mayo Clinic, Rochester, Minn. 55905.
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