Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome

Background. Acute coronary syndrome (ACS) can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods. This is a single center, retrospective study...

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Main Authors: Sylvia Marie Biso, Marvin Lu, Toni Anne De Venecia, Supakanya Wongrakpanich, Mary Rodriguez-Ziccardi, Sujani Yadlapati, Marina Kishlyansky, Harish Seetha Rammohan, Vincent M. Figueredo
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2017/3762149
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author Sylvia Marie Biso
Marvin Lu
Toni Anne De Venecia
Supakanya Wongrakpanich
Mary Rodriguez-Ziccardi
Sujani Yadlapati
Marina Kishlyansky
Harish Seetha Rammohan
Vincent M. Figueredo
author_facet Sylvia Marie Biso
Marvin Lu
Toni Anne De Venecia
Supakanya Wongrakpanich
Mary Rodriguez-Ziccardi
Sujani Yadlapati
Marina Kishlyansky
Harish Seetha Rammohan
Vincent M. Figueredo
author_sort Sylvia Marie Biso
collection DOAJ
description Background. Acute coronary syndrome (ACS) can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods. This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-cause mortality. Results. Of the 82 patients, 32% had chest pain and 88% had ischemic ECG changes; mean peak troponin level was 18, and mean ejection fraction was 40%. The medical management group had older individuals (73 versus 67 years, p<0.05), lower mean peak troponin levels (12 versus 49, p<0.05), and lower mean length of stay (12 versus 25 days, p<0.05) compared to those who underwent stent or CABG. Troponin levels were significantly associated with 1-year all-cause mortality. Conclusion. Age and troponin level appear to play a role in the current clinical decision making for patient with suspected poststroke ACS. Troponin level appears to significantly correlate with 1-year all-cause mortality. In the management of poststroke acute coronary syndrome, optimal medical therapy had similar inpatient and all-cause mortality compared to PCI and/or CABG.
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spelling doaj-art-b49fc3cbfe84476eb865288b84acf7ab2025-08-20T02:23:28ZengWileyCardiology Research and Practice2090-80162090-05972017-01-01201710.1155/2017/37621493762149Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary SyndromeSylvia Marie Biso0Marvin Lu1Toni Anne De Venecia2Supakanya Wongrakpanich3Mary Rodriguez-Ziccardi4Sujani Yadlapati5Marina Kishlyansky6Harish Seetha Rammohan7Vincent M. Figueredo8Department of Medicine, Einstein Medical Center, 5401 Old York Road, Suite 363, Philadelphia, PA 19141, USADepartment of Medicine, Einstein Medical Center, 5401 Old York Road, Suite 363, Philadelphia, PA 19141, USADepartment of Medicine, Einstein Medical Center, 5401 Old York Road, Suite 363, Philadelphia, PA 19141, USADepartment of Medicine, Einstein Medical Center, 5401 Old York Road, Suite 363, Philadelphia, PA 19141, USADepartment of Medicine, Einstein Medical Center, 5401 Old York Road, Suite 363, Philadelphia, PA 19141, USADepartment of Medicine, Einstein Medical Center, 5401 Old York Road, Suite 363, Philadelphia, PA 19141, USADepartment of Medicine, Einstein Medical Center, 5401 Old York Road, Suite 363, Philadelphia, PA 19141, USABassett Medical Center, Bassett Healthcare Network, Cooperstown, NY, USAEinstein Institute for Heart and Vascular Health, Einstein Medical Center, Philadelphia, PA, USABackground. Acute coronary syndrome (ACS) can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking. Methods. This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-cause mortality. Results. Of the 82 patients, 32% had chest pain and 88% had ischemic ECG changes; mean peak troponin level was 18, and mean ejection fraction was 40%. The medical management group had older individuals (73 versus 67 years, p<0.05), lower mean peak troponin levels (12 versus 49, p<0.05), and lower mean length of stay (12 versus 25 days, p<0.05) compared to those who underwent stent or CABG. Troponin levels were significantly associated with 1-year all-cause mortality. Conclusion. Age and troponin level appear to play a role in the current clinical decision making for patient with suspected poststroke ACS. Troponin level appears to significantly correlate with 1-year all-cause mortality. In the management of poststroke acute coronary syndrome, optimal medical therapy had similar inpatient and all-cause mortality compared to PCI and/or CABG.http://dx.doi.org/10.1155/2017/3762149
spellingShingle Sylvia Marie Biso
Marvin Lu
Toni Anne De Venecia
Supakanya Wongrakpanich
Mary Rodriguez-Ziccardi
Sujani Yadlapati
Marina Kishlyansky
Harish Seetha Rammohan
Vincent M. Figueredo
Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome
Cardiology Research and Practice
title Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome
title_full Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome
title_fullStr Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome
title_full_unstemmed Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome
title_short Clinical Characteristics, Management, and Outcomes of Suspected Poststroke Acute Coronary Syndrome
title_sort clinical characteristics management and outcomes of suspected poststroke acute coronary syndrome
url http://dx.doi.org/10.1155/2017/3762149
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