Abstract Details

Title Myocardial Infarction and Pneumonia as Predictors of Mortality in Patients with Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P03 - (-)

Poster/Presentation
Number 192

Objective

Background BACKGROUND: Although many investigators have focused on AIS after a MI, few have analyzed the effect of MI on patients with AIS. MI may significantly affect cerebral perfusion and neurological outcome.

Design/Methods DESIGN/METHODS: Consecutive AIS patients were retrospectively identified at a single center (07/08-12/10) and included if echocardiography was performed. MI was defined as troponin >1.0ng/mL with clinical symptoms or electrocardiogram changes. Univariate analyses were performed using Pearson chi-square and Kruskal-Wallis tests. The association between in-hospital MI, pneumonia, and in-hospital mortality was examined using logistic regression.

Results RESULTS: Of 590 patients screened, 426 were included (mean age 64, 73% Black, 48% female). There was no significant difference in demographics between the MI and non-MI groups. More severe strokes were seen in patients who later suffered a MI (median National Institutes of Health Stroke Scale [NIHSS] 7 vs. 5, p=0.014). More patients with a MI experienced pneumonia (26% vs. 9%, p=0.004) and in-hospital mortality (21% vs. 6%, p=0.001). After adjusting for age, baseline glucose and NIHSS, the odds of in-hospital mortality for patients with MI was 3 times that of those without MI (OR 3.2 95%CI 1.1-9.7, p=0.036). Because pneumonia was associated with exposure of interest (MI) and outcome of interest (death), we added pneumonia to the model, and MI was no longer significantly related to in-hospital mortality (OR 2.5 95%CI 0.8-8.2, p=0.131).

Conclusions CONCLUSIONS: In our population, MI was significantly associated with in-hospital mortality after adjusting for age, NIHSS, and glucose. This affect is no longer significant after adjusting for presence of pneumonia. These findings raise the question as to whether the prevention of pneumonia could improve mortality in AIS patients with MI.

Authors/Disclosures
Tiffany Mathias PRESENTER	No disclosure on file
Karen C. Albright, DO, DO, PhD, MS, MPH (FDA)	Dr. Albright has nothing to disclose.
	No disclosure on file
Noah Rosen, MD, FAAN	Dr. Rosen has received personal compensation for serving as an employee of Northwell Health. An immediate family member of Dr. Rosen has received personal compensation for serving as an employee of New York University. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer . Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Pfizer. Dr. Rosen has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer.
James E. Siegler III, MD (University of Chicago)	Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siegler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serb. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wallaby Phenox. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke: Vascular and Interventional Neurology. Dr. Siegler has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Precision Medicine, LLC. The institution of Dr. Siegler has received research support from Philips. The institution of Dr. Siegler has received research support from Medtronic.
Amelia K. Boehme, PhD (Columbia University)	Dr. Boehme has nothing to disclose.
Sheryl Martin-Schild, MD, PhD, FAAN (Dr. Brain, Inc.)	No disclosure on file

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