Risk, mechanisms and prevention of stroke after an acute myocardial infarction.

This review focuses on risk, mechanisms and prevention of stroke after an acute myocardial infarction. Pathophysiological aspects are covered and in particular, the relationship between ventricular thrombi and stroke is critically reviewed. New aspects concerning platelet activation and thrombotic risk is discussed. Epidemiological data are reviewed to form a background for a discussion concerning the absolute risk of stroke in different age-groups and the importance of different risk-factors. The common view that anterior location of an infarction is of major importance is challenged. Treatment options for prevention of ischemic, as well hemorrhagic, stroke is covered in detail. The author's opinion regarding practical clinical strategies, as well as more speculative comments about the future in the field, is included.