Biso Sylvia Marie, Lu Marvin, De Venecia Toni Anne, Wongrakpanich Supakanya, Rodriguez-Ziccardi Mary, Yadlapati Sujani, Kishlyansky Marina, Rammohan Harish Seetha, Figueredo Vincent M
Department of Medicine, Einstein Medical Center, 5401 Old York Road, Suite 363, Philadelphia, PA 19141, USA.
Bassett Medical Center, Bassett Healthcare Network, Cooperstown, NY, USA.
Cardiol Res Pract. 2017;2017:3762149. doi: 10.1155/2017/3762149. Epub 2017 Oct 9.
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.
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.
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, < 0.05), lower mean peak troponin levels (12 versus 49, < 0.05), and lower mean length of stay (12 versus 25 days, < 0.05) compared to those who underwent stent or CABG. Troponin levels were significantly associated with 1-year all-cause mortality.
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.
急性冠状动脉综合征（ACS）可使急性缺血性卒中复杂化，导致显著的发病率和死亡率。迄今为止，缺乏描述卒中后急性冠状动脉综合征及其发病率和死亡率负担的文献。
这是一项单中心回顾性研究，比较并分析了疑似卒中后ACS患者的临床特征、心脏评估及治疗与住院死亡率和1年全因死亡率的相关性。
82例患者中，32%有胸痛，88%有缺血性心电图改变；肌钙蛋白峰值平均水平为18，射血分数平均为40%。与接受支架置入术或冠状动脉旁路移植术（CABG）的患者相比，药物治疗组患者年龄更大（73岁对67岁，P<0.05），肌钙蛋白峰值平均水平更低（12对49，P<0.05），平均住院时间更短（12天对25天，P<0.05）。肌钙蛋白水平与1年全因死亡率显著相关。
年龄和肌钙蛋白水平似乎在目前疑似卒中后ACS患者的临床决策中发挥作用。肌钙蛋白水平似乎与1年全因死亡率显著相关。在卒中后急性冠状动脉综合征的治疗中，与经皮冠状动脉介入治疗（PCI）和/或CABG相比，最佳药物治疗的住院死亡率和全因死亡率相似。
