Mohammed Yousufuddin1, Nathan Young2, Lawrence Keenan2, Tammy Olson2, Jessica Shultz2, Taylor Doyle2, Eimad M Ahmmad2, Kogulavadanan Arumaithurai2, Paul Takahashi2, Mohammad Hassan Murad2. 1. From the Division of Internal Medicine, Mayo Clinic Health System, Austin, MN (M.Y., L.K., T.O., J.S., T.D., E.M.A., K.A.); and Division of Internal Medicine, Mayo Clinic, Rochester, MN (N.Y., P.T., M.H.M.). yousufuddin.mohammed@mayo.edu. 2. From the Division of Internal Medicine, Mayo Clinic Health System, Austin, MN (M.Y., L.K., T.O., J.S., T.D., E.M.A., K.A.); and Division of Internal Medicine, Mayo Clinic, Rochester, MN (N.Y., P.T., M.H.M.).
Abstract
BACKGROUND AND PURPOSE: We aimed at providing estimates of mortality associated with cardiometabolic comorbidity and incident readmission from cardiometabolic as compared with noncardiometabolic conditions after a first transient ischemic attack. METHODS: Between 2000 and 2015, patients hospitalized for a first transient ischemic attack were examined for cardiometabolic comorbidities (diabetes mellitus, coronary artery disease, heart failure, and atrial fibrillation), 5-year incident hospitalization, and time to death. RESULTS: Of 251 patients with transient ischemic attack, 134 (53%) had at least 1 and 55 (22%) had at least 2 cardiometabolic conditions. By 5 years, 491 readmissions (134 [27%] cardiometabolic and 357 [73%] noncardiometabolic) and 75 deaths (27 [36%] cardiometabolic and 47 [64%] noncardiometabolic) were observed. Mortality was increased with any concurrent cardiometabolic comorbidity (hazard ratio, 1.89; 95% confidence interval, 1.17-3.03; P=0.0089) with multiplicative mortality risk from a combination of coronary artery disease and heart failure. Each hospitalization was associated with a 1.5-fold risk of death (95% confidence interval, 1.37-1.64; P<0.0001). Risk of cardiometabolic and noncardiometabolic mortality was correlated with the corresponding category-specific readmission. CONCLUSIONS: Among patients hospitalized for first transient ischemic attack, 5-year mortality is associated with concurrent cardiometabolic comorbidity and rates of subsequent hospitalization.
BACKGROUND AND PURPOSE: We aimed at providing estimates of mortality associated with cardiometabolic comorbidity and incident readmission from cardiometabolic as compared with noncardiometabolic conditions after a first transient ischemic attack. METHODS: Between 2000 and 2015, patients hospitalized for a first transient ischemic attack were examined for cardiometabolic comorbidities (diabetes mellitus, coronary artery disease, heart failure, and atrial fibrillation), 5-year incident hospitalization, and time to death. RESULTS: Of 251 patients with transient ischemic attack, 134 (53%) had at least 1 and 55 (22%) had at least 2 cardiometabolic conditions. By 5 years, 491 readmissions (134 [27%] cardiometabolic and 357 [73%] noncardiometabolic) and 75 deaths (27 [36%] cardiometabolic and 47 [64%] noncardiometabolic) were observed. Mortality was increased with any concurrent cardiometabolic comorbidity (hazard ratio, 1.89; 95% confidence interval, 1.17-3.03; P=0.0089) with multiplicative mortality risk from a combination of coronary artery disease and heart failure. Each hospitalization was associated with a 1.5-fold risk of death (95% confidence interval, 1.37-1.64; P<0.0001). Risk of cardiometabolic and noncardiometabolic mortality was correlated with the corresponding category-specific readmission. CONCLUSIONS: Among patients hospitalized for first transient ischemic attack, 5-year mortality is associated with concurrent cardiometabolic comorbidity and rates of subsequent hospitalization.
Authors: Shreyansh Shah; Li Liang; Durgesh Bhandary; Saga Johansson; Eric E Smith; Deepak L Bhatt; Gregg C Fonarow; Naeem D Khan; Eric Peterson; Janet Prvu Bettger Journal: Stroke Vasc Neurol Date: 2020-11-04