Coronary artery disease, myocardial infarction, and brain embolism

D. C. Hess, I. A. D'Cruz, R. J. Adams, F. T. Nichols

Research output: Contribution to journalReview article

24 Scopus citations

Abstract

The incidence of in-hospital stroke complicating acute myocardial infarction is approximately 1%. This rate is largely unaffected by thrombolytic therapy. Large myocardial infarctions, anterior wall involvement, prior stroke, and increasing age are risk factors for ischemic stroke. Left ventricular thrombi commonly occur with anterior wall infarctions. There is some evidence that anticoagulation reduces their incidence and uncontrolled studies suggest that anticoagulation may reduce the risk of embolization. Left ventricular aneurysms have a low rate of embolization and do not require systemic anticoagulation. Treatment of acute myocardial infarction with t-PA and anisoylated plasminogen streptokinase activator complex are associated with a higher risk of stroke than treatment with streptokinase; this excess risk is attributable to an increased rate of cerebral hemorrhages.

Original languageEnglish (US)
Pages (from-to)399-417
Number of pages19
JournalNeurologic Clinics
Volume11
Issue number2
DOIs
StatePublished - 1993
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology

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