Patients with intracerebral hemorrhage at greater risk for cardiovascular events
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Patients with stroke due to nontraumatic intracerebral hemorrhage had significantly higher rates of major adverse cardiovascular events, researchers reported in JAMA Network Open.
David Gaist, MD, PhD, professor and neurologist at Odense University Hospital and University of Southern Denmark, and colleagues aimed to assess the risk for major adverse cardiovascular events in patients with prior intracerebral hemorrhage compared with the general population.
Researchers identified 8,991 patients (53.5% men; mean age, 70.7 years) with a first intracerebral hemorrhage in the Danish Stroke Registry from Jan. 1, 2005, to June 30, 2018, who were aged 45 years or older and survived more than 30 days after stroke. Patients in this cohort were matched 1:40 with a comparison cohort of 359,185 individuals from the general population.
According to study results, those in the intracerebral hemorrhage cohort had higher event rates for major adverse cardiovascular events than the general population — 4.16 per 100 person-years (95% CI, 3.96-4.37) compared with 1.35 (95% CI, 1.33-1.36; adjusted HR = 3.13 [95% CI, 2.97-3.3]).
Additionally, those in the hemorrhage group had higher rates of ischemic stroke (1.52 per 100 person-years [95% CI, 1.4-1.65] vs. 0.56 [95% CI, 0.55-0.57]; aHR = 2.64 [95% CI, 2.43-2.88]) and intracerebral hemorrhage (1.44 per 100 person-years [95% CI, 1.32-1.56] vs. 0.06 [95% CI, 0.06-0.07]; aHR = 23.49 [95% CI, 21.12-26.13]).
However, researchers reported similar rates of myocardial infarction in the hemorrhage group (0.52 per 100 person-years; [95% CI, 0.45-0.6]) compared with the general population (0.48; [95% CI, 0.47-0.49]; aHR = 1.12 [95% CI, 0.97-1.29]).
“Compared with controls from the general population, patients with a prior [intracerebral hemorrhage] were at increased risk of both hemorrhagic and ischemic vascular events (except [myocardial infarction]), associations that were present for both sexes and all age groups and regardless of prior comorbidity,” the authors wrote.