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In the United States, myocardial infarction and stroke are the main causes of death.
Because myocardial infarction and ischemic stroke have common risk factors and are obviously related.
Cerebral hemorrhage is the most common type of hemorrhagic stroke, so cerebral hemorrhage and arterial ischemic events such as myocardial infarction and ischemic stroke also have common risk factors.
Large-scale case series studies have shown that myocardial infarction and ischemic stroke after cerebral hemorrhage are not uncommon, but previous studies still lack a control group (no cerebral hemorrhage group).
Therefore, it is not clear whether cerebral hemorrhage increases the risk of subsequent myocardial infarction and ischemic stroke.
The team of Professor Santosh B from the Weill Cornell School of Medicine in the United States used aggregate data from 4 population-based studies to explore the relationship between cerebral hemorrhage and arterial ischemia events.
Yimaitong compiles and organizes, please do not reprint without authorization.
Research Introduction The researchers collected longitudinal data from 4 population-based cohort studies in the United States, including the Community Atherosclerosis Risk Study (ARIC), the Cardiovascular Health Study (CHS), the Northern Manhattan Study (NOMAS), and stroke Research on the Causes of Geographical and Ethnic Differences (REGARDS) and analyze the data from September 1, 2019 to March 31, 2020.
The main outcome of this study was an arterial ischemic event, which was defined as the composite end point of ischemic stroke and myocardial infarction.
The secondary outcomes were simple ischemic stroke and simple myocardial infarction.
In each study, all potential strokes and myocardial infarction cases were determined by a group of researchers in accordance with the protocol of each study.
Ischemic stroke is uniformly defined as a sudden or rapid neurological symptom that lasts more than 24 hours or leads to death, and has no other obvious cause (such as bleeding, trauma, tumor, or infection).
The definition of myocardial infarction is based on a combination of diagnostic myocardial enzymes, electrocardiogram, and signs or symptoms of ischemia.
This study used Cox proportional hazards regression to analyze the relationship between cerebral hemorrhage and subsequent arterial ischemic events.
Main findings: ➤Among the 55,131 participants, 47,866 (of which 27,639 were women [57.
7%]; average [SD] age, 62.
2 [10.
2] years) met the analysis criteria.
With a median follow-up of 12.
7 years (interquartile range, 7.
7-19.
5 years), 318 cases of cerebral hemorrhage and 7,648 cases of arterial ischemic events occurred.
➤The incidence of arterial ischemic events after cerebral hemorrhage was 3.
6 cases/100 person-years (95%CI: 2.
7-5.
0 cases/100 person-years), while the incidence of patients without cerebral hemorrhage was 1.
1 cases/100 person-years (95%CI: 1.
1-1.
2 cases/100 person-years).
In the calibration model, cerebral hemorrhage and arterial ischemic events (HR: 2.
3; 95%CI: 1.
7-3.
1), ischemic stroke (HR: 3.
1; 95%CI: 2.
1-4.
5) and myocardial infarction (HR: 1.
9; 95%CI: 1.
2-2.
9) correlated.
➤In the sensitivity analysis, when covariates are updated with time-varying nature (HR: 2.
2; 95% CI: 1.
6-3.
0); when frequency matching is used (OR: 2.
3; 95% CI, 1.
3-4.
2); including universal brain Participants with hemorrhage, ischemic stroke, or myocardial infarction (HR: 2.
2; 95%CI: 1.
6-2.
9); when death is used as a competitive risk (subdistribution HR: 1.
6; 95%CI: 1.
1-2.
1), brain Bleeding is related to arterial ischemic events.
Research conclusions In this large, heterogeneous longitudinal data sample, the researchers found that cerebral hemorrhage was associated with an increased risk of subsequent ischemic stroke and myocardial infarction.
These findings suggest that cerebral hemorrhage may be a new risk marker of arterial ischemic events.
Yimaitong compiled from: Association Between Intracerebral Hemorrhage and Subsequent Arterial Ischemic Events in Participants From 4 Population-Based Cohort Studies.
JAMA Neurol.
2021 May 3.
doi: 10.
1001/jamaneurol.
2021.
0925.
Epub ahead of print.
PMID: 33938907.
Because myocardial infarction and ischemic stroke have common risk factors and are obviously related.
Cerebral hemorrhage is the most common type of hemorrhagic stroke, so cerebral hemorrhage and arterial ischemic events such as myocardial infarction and ischemic stroke also have common risk factors.
Large-scale case series studies have shown that myocardial infarction and ischemic stroke after cerebral hemorrhage are not uncommon, but previous studies still lack a control group (no cerebral hemorrhage group).
Therefore, it is not clear whether cerebral hemorrhage increases the risk of subsequent myocardial infarction and ischemic stroke.
The team of Professor Santosh B from the Weill Cornell School of Medicine in the United States used aggregate data from 4 population-based studies to explore the relationship between cerebral hemorrhage and arterial ischemia events.
Yimaitong compiles and organizes, please do not reprint without authorization.
Research Introduction The researchers collected longitudinal data from 4 population-based cohort studies in the United States, including the Community Atherosclerosis Risk Study (ARIC), the Cardiovascular Health Study (CHS), the Northern Manhattan Study (NOMAS), and stroke Research on the Causes of Geographical and Ethnic Differences (REGARDS) and analyze the data from September 1, 2019 to March 31, 2020.
The main outcome of this study was an arterial ischemic event, which was defined as the composite end point of ischemic stroke and myocardial infarction.
The secondary outcomes were simple ischemic stroke and simple myocardial infarction.
In each study, all potential strokes and myocardial infarction cases were determined by a group of researchers in accordance with the protocol of each study.
Ischemic stroke is uniformly defined as a sudden or rapid neurological symptom that lasts more than 24 hours or leads to death, and has no other obvious cause (such as bleeding, trauma, tumor, or infection).
The definition of myocardial infarction is based on a combination of diagnostic myocardial enzymes, electrocardiogram, and signs or symptoms of ischemia.
This study used Cox proportional hazards regression to analyze the relationship between cerebral hemorrhage and subsequent arterial ischemic events.
Main findings: ➤Among the 55,131 participants, 47,866 (of which 27,639 were women [57.
7%]; average [SD] age, 62.
2 [10.
2] years) met the analysis criteria.
With a median follow-up of 12.
7 years (interquartile range, 7.
7-19.
5 years), 318 cases of cerebral hemorrhage and 7,648 cases of arterial ischemic events occurred.
➤The incidence of arterial ischemic events after cerebral hemorrhage was 3.
6 cases/100 person-years (95%CI: 2.
7-5.
0 cases/100 person-years), while the incidence of patients without cerebral hemorrhage was 1.
1 cases/100 person-years (95%CI: 1.
1-1.
2 cases/100 person-years).
In the calibration model, cerebral hemorrhage and arterial ischemic events (HR: 2.
3; 95%CI: 1.
7-3.
1), ischemic stroke (HR: 3.
1; 95%CI: 2.
1-4.
5) and myocardial infarction (HR: 1.
9; 95%CI: 1.
2-2.
9) correlated.
➤In the sensitivity analysis, when covariates are updated with time-varying nature (HR: 2.
2; 95% CI: 1.
6-3.
0); when frequency matching is used (OR: 2.
3; 95% CI, 1.
3-4.
2); including universal brain Participants with hemorrhage, ischemic stroke, or myocardial infarction (HR: 2.
2; 95%CI: 1.
6-2.
9); when death is used as a competitive risk (subdistribution HR: 1.
6; 95%CI: 1.
1-2.
1), brain Bleeding is related to arterial ischemic events.
Research conclusions In this large, heterogeneous longitudinal data sample, the researchers found that cerebral hemorrhage was associated with an increased risk of subsequent ischemic stroke and myocardial infarction.
These findings suggest that cerebral hemorrhage may be a new risk marker of arterial ischemic events.
Yimaitong compiled from: Association Between Intracerebral Hemorrhage and Subsequent Arterial Ischemic Events in Participants From 4 Population-Based Cohort Studies.
JAMA Neurol.
2021 May 3.
doi: 10.
1001/jamaneurol.
2021.
0925.
Epub ahead of print.
PMID: 33938907.
