Abstract 15628: Incidence, Complications, and Outcomes of Non - ST Elevation Myocardial Infarction in Patients Presenting With Acute Ischemic Stroke

Abstract

Background: Acute myocardial infarction may concomitantly occur with acute ischemic stroke. The incidence,complications and outcomes of acute Non- ST elevation Myocardial infarction in acute ischemic stroke are not well studied. Methods: We examined hospitalized patients (n = 1,726,265) with acute ischemic stroke that were included in National Inpatient Sample 2016-2019. Acute ischemic stroke and NSTEMI were defined by using International classification of disease (ICD -10). STEMI patients were excluded. Multivariable logistic regression analysis was used to examine association of NSTEMI with outcomes. A subgroup analysis of NSTEMI patients that underwent PCI (with or without angioplasty) was also performed. Results: Of the total stroke patients, 27630 (1.6%) patients (mean age 73.5, 52.2% females) had NSTEMI diagnosed during the hospitalization. Of these, 3890 (6.32%) died in NSTEMI group and 57670 (93.68%) died in non NSTEMI group. The commonest complications in NSTEMI group were cardiogenic shock 25% , cardiac tamponade 13.8% , and septic shock 12.1%. NSTEMI in stroke patients were associated with several complications and mortality (OR 2.73, 95% CI 2.57-2.90, p value <0.001). While, PCI was performed in 43.3% of NSTEMI patients, there was no increase in bleeding complications and there was reduced risk of mortality associated with PCI (OR 0.34, 95% CI 0.22-0.52, p<0.001)[FIGURE]. Conclusion: NSTEMI even though not frequent in patients with stroke but was associated with increased risk of complications and mortality. PCI was associated with reduced risk of mortality and no increase in bleeding complications.