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(Stroke. 2006;37:2449.)
© 2006 American Heart Association, Inc.

Editorials

Acute Myocardial Infarction, Ischemic Stroke, Sympathetic Stress, and Inflammation

Birds of a Feather

Jose I. Suarez, MD

From the Department of Neurology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio.

Correspondence to Jose I. Suarez, MD, Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH. E-mail jose.suarez@uhhs.com

Key Words: acute myocardial infarction • acute stroke • inflammation • sympathethic stress • thrombolysis

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 2546–2551

Stroke, the leading cause of neurological death, is the leading cause of disability in the US.¹ Ischemic stroke represents about 85% of all strokes and is a heterogeneous condition. Generally speaking, ischemic strokes can be classified into different categories according to their presumed mechanism as follows: infarct with large artery thrombosis; embolism attributed to cardiac sources or cardioembolic; lacunar infarction; or cryptogenic infarction or infarct of undetermined cause.² Cardioembolic strokes are a major mechanism of ischemic strokes with nonvalvular atrial fibrillation alone accounting for about 25% of all ischemic events.³ Other cardiac conditions that have been associated with cardioembolic strokes include acute myocardial infarction (AMI), ventricular aneurysm, rheumatic valvular disease, mechanical prosthetic valve, and left atrial or ventricular thrombi to name the most common.

The association between ischemic stroke and AMI has been recognized for several decades. The risk of ischemic stroke in patients presenting with AMI has declined from 2.4% to 3.5% in earlier reports to about 0.6% to 1.8% in more recent studies incorporating thrombolytic or anticoagulant therapy in the acute phase.^4–6 Despite such infrequent occurrence of ischemic strokes after AMI, the outcome of patients is poor with high mortality (17%) and disability (80%).⁵

It is commonly accepted that the relationship between ischemic strokes in the setting of AMI is most likely multifactorial. Factors frequently cited in the literature include older age, history of prior stroke, diabetes, or hypertension, and the presence of large akinetic segments of myocardium with or without left . . . [Full Text of this Article]

Related Article:

Early Coronary Revascularization Diminishes the Risk of Ischemic Stroke With Acute Myocardial Infarction

Eric Van De Graaff, Monisha Dutta, Pranab Das, Eric A. Shry, Paul D. Frederick, Martha Blaney, David J. Pasta, and Steven R. Steinhubl
Stroke 2006 37: 2546-2551. [Abstract] [Full Text] [PDF]