Greater Heart Disease Risk Following Stroke

The risk of dying from heart disease after suffering a stroke is far greater than that of dying from another stroke, researchers have discovered. A study published in the journal Neurology shows that stroke patients are almost twice as likely to die from heart disease after a first stroke, than from a second stroke.

In the long run, however, non-fatal strokes are far more likely to occur than cardiac events. Dr. M. S. V. Elkind and colleagues from Columbia University, New York, who authored the study, say their research is among the few long-term follow-up studies to compare the risks of recurrent stroke and cardiac events after a first ischemic stroke. Such a study is important because "the relative risk of these two outcomes may inform treatment decisions".

Ischemic strokes occur when the brain does not receive enough oxygen, which usually happens because of a blood clot. The rupture of a blood vessel leads to a hemorrhagic stroke (caused by bleeding).

The researchers looked at 655 patients enrolled in the population-based Northern Manhattan Study, of average age 69.7 years. These patients had suffered an ischemic stroke and were followed for heart attack, stroke and death.

Death from cardiac events included death from a heart attack, death from congestive heart failure, sudden death caused by arrhythmias and cardiopulmonary arrest.

After 5 years, the results indicated that the risk of recurrent stroke was more than two times higher than that of a cardiac event (18.3% versus 8.6%); the risk of non-fatal stroke was about twice as high as that of having a fatal cardiac event (14.8%, compared to 6.4%), and 4 times higher than the risk of a fatal stroke (3.7%).

Thus, the risk of a fatal cardiac event (6.4%) was found to be almost double as compared to the risk of having a fatal stroke (3.7%).

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