OBJECTIVE:Patients with cerebral ischemia have a high mortality rate. The most common cause of death is myocardial infarction. We attempted to identify risk factors for subsequent cardiac events in patients with cerebral ischemia by means of the history and electrocardiography performed with the patient at rest. DESIGN: The original inception cohort was entered in a multicenter randomized clinical trial (30 or 283 mg/d of aspirin) and followed up prospectively for a mean period of 2.6 years. SETTING:Patients were admitted to the hospital or seen in outpatient clinics. PATIENTS: Patients with one or more transient ischemic attacks (symptoms completely reversible within 24 hours) and patients with minor ischemic stroke (symptoms persisting for longer than 24 hours) were randomized, provided they were independent in most activities of daily living. Patients with a definite or probable source of embolism in the heart were excluded. A total of 3021 patients were included in the study. Follow-up was performed at 4-month intervals. MAIN OUTCOME MEASURES: Primary cardiac outcome events were defined as nonfatal myocardial infarction and cardiac death. Cardiac death included sudden death, fatal myocardial infarction, or death due to congestive heart failure; 189 patients suffered a cardiac death--82 of which were sudden deaths--or nonfatal myocardial infarction. RESULTS: By means of multivariate analysis, the following independent predictors for cardiac events were identified (hazards ratio/95% confidence limits): age older than 65 years (1.6/1.2 to 2.2), male sex (1.5/1.1 to 2.1), angina pectoris (1.5/1.0 to 2.3), diabetes (1.6/1.1 to 2.5), anterior infarction noted on electrocardiography (1.7/1.1 to 2.7), inverted T wave noted on the electrocardiogram (1.6/1.1 to 2.4), and left ventricular hypertrophy noted on electrocardiography (3.2/2.0 to 4.9). CONCLUSIONS: The history and the electrocardiogram obtained with the patient at rest are valuable tools for cardiac risk assessment in patients with recent cerebral ischemia.
RCT Entities:
OBJECTIVE:Patients with cerebral ischemia have a high mortality rate. The most common cause of death is myocardial infarction. We attempted to identify risk factors for subsequent cardiac events in patients with cerebral ischemia by means of the history and electrocardiography performed with the patient at rest. DESIGN: The original inception cohort was entered in a multicenter randomized clinical trial (30 or 283 mg/d of aspirin) and followed up prospectively for a mean period of 2.6 years. SETTING:Patients were admitted to the hospital or seen in outpatient clinics. PATIENTS: Patients with one or more transient ischemic attacks (symptoms completely reversible within 24 hours) and patients with minor ischemic stroke (symptoms persisting for longer than 24 hours) were randomized, provided they were independent in most activities of daily living. Patients with a definite or probable source of embolism in the heart were excluded. A total of 3021 patients were included in the study. Follow-up was performed at 4-month intervals. MAIN OUTCOME MEASURES: Primary cardiac outcome events were defined as nonfatal myocardial infarction and cardiac death. Cardiac death included sudden death, fatal myocardial infarction, or death due to congestive heart failure; 189 patients suffered a cardiac death--82 of which were sudden deaths--or nonfatal myocardial infarction. RESULTS: By means of multivariate analysis, the following independent predictors for cardiac events were identified (hazards ratio/95% confidence limits): age older than 65 years (1.6/1.2 to 2.2), male sex (1.5/1.1 to 2.1), angina pectoris (1.5/1.0 to 2.3), diabetes (1.6/1.1 to 2.5), anterior infarction noted on electrocardiography (1.7/1.1 to 2.7), inverted T wave noted on the electrocardiogram (1.6/1.1 to 2.4), and left ventricular hypertrophy noted on electrocardiography (3.2/2.0 to 4.9). CONCLUSIONS: The history and the electrocardiogram obtained with the patient at rest are valuable tools for cardiac risk assessment in patients with recent cerebral ischemia.
Authors: M L Bots; Y Nikitin; J T Salonen; P C Elwood; S Malyutina; A Freire de Concalves; J Sivenius; A Di Carlo; P Lagiou; J Tuomilehto; P J Koudstaal; D E Grobbee Journal: J Epidemiol Community Health Date: 2002-02 Impact factor: 3.710
Authors: Abiodun M Adeoye; Okechukwu S Ogah; Bruce Ovbiagele; Rufus Akinyemi; Vincent Shidali; Francis Agyekum; Akinyemi Aje; Oladimeji Adebayo; Joshua O Akinyemi; Philip Kolo; Lambert Tetteh Appiah; Henry Iheonye; Uwanuruochi Kelechukwu; Amusa Ganiyu; Taiwo O Olunuga; Onoja Akpa; Ojo Olakanmi Olagoke; Fred Stephen Sarfo; Kolawole Wahab; Samuel Olowookere; Adekunle Fakunle; Albert Akpalu; Philip B Adebayo; Kwadwo Nkromah; Joseph Yaria; Philip Ibinaiye; Godwin Ogbole; Aridegbe Olumayowa; Sulaiman Lakoh; Benedict Calys-Tagoe; Paul Olowoyo; Chukwuonye Innocent; Hemant K Tiwari; Donna Arnett; Osaigbovo Godwin; Bisi Ayotunde; Josephine Akpalu; Okeke Obiora; Odo Joseph; Adeleye Omisore; Carolyn Jenkins; Daniel Lackland; Lukman Owolabi; Suleiman Isah; Abdu H Dambatta; Morenikeji Komolafe; Andrew Bock-Oruma; Ezinne Sylvia Melikam; Lucius Chidiebere Imoh; Taofiki Sunmonu; Mulugeta Gebregziabher; Oluyemisi Olabisi; Kevin Armstrong; Ugochukwu U Onyeonoro; Emmanuel Sanya; Atinuke M Agunloye; Luqman Ogunjimi; Oyedunni Arulogun; Temitope H Farombi; Olugbo Obiabo; Reginald Obiako; Mayowa Owolabi Journal: Glob Heart Date: 2017-03-14