| Risk of myocardial infarction and vascular death after transient ischemic attack and ischemic stroke: a systematic review and meta-analysis. | |
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MedLine Citation:
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PMID: 16254218 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Whether stroke patients should be investigated for asymptomatic coronary artery disease remains matter of debate. Absolute risks of myocardial infarction (MI) and vascular death after a stroke have not been accurately assessed. We performed a systematic review and a meta-analysis to determine the risk of MI and nonstroke vascular death after transient ischemic attack (TIA) and ischemic stroke. Cohort studies of TIA or ischemic stroke patients were included if they were published between 1980 and March 2005, reported risk of MI and nonstroke vascular death, enrolled >100 patients, and had at least 1 year of follow-up. We included 39 studies in a total of 65,996 patients with mean follow-up of 3.5 years. Two reviewers independently carried out data extraction using a standardized form. Absolute annual risks were estimated through weighted meta-regressions with a random effect. To test the predictions of expected event rates derived from our analysis, we used individual patient data. SUMMARY OF REVIEW: The annual risks were 2.1% (CI 95%: 1.9 to 2.4) for nonstroke vascular death, 2.2% (1.7 to 2.7) for total MI, 0.9% (0.7 to 1.2) for nonfatal MI and 1.1% (0.8 to 1.5) for fatal MI. The time course of risk was linear. Estimated risks fitted well with observed risks at the individual level. There was no heterogeneity in the absolute risks according to baseline study characteristics. CONCLUSIONS: Patients with TIA or stroke have a relatively high risk of MI and nonstroke vascular death. Additional research is needed to identify the determinants of coronary artery disease in stroke patients. |
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Authors:
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Emmanuel Touzé; Olivier Varenne; Gilles Chatellier; Séverine Peyrard; Peter M Rothwell; Jean-Louis Mas |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review Date: 2005-10-27 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 36 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2005 Dec |
Date Detail:
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Created Date: 2005-11-23 Completed Date: 2005-12-22 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 2748-55 Citation Subset: IM |
Affiliation:
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Department of Neurology, Hôpital Sainte-Anne, Université Paris-Descartes, Faculté de Médecine, Paris Cedex 14. e.touze@ch-sainte-anne.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cause of Death* Comorbidity Female Follow-Up Studies Humans Incidence Ischemic Attack, Transient / epidemiology* Male Myocardial Infarction / epidemiology* Regression Analysis Risk Assessment Stroke / epidemiology* Survival Analysis |
| Comments/Corrections | |
Comment In:
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ACP J Club. 2006 Jul-Aug;145(1):23
[PMID:
16813371
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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