The association of stroke and coronary heart disease: a population study.

In a 20-year population-based study (1960 through 1979), we estimated the cumulative probability of (1) the occurrence of stroke after a diagnosis of angina pectoris, (2) the occurrence of stroke after a diagnosis of myocardial infarction, and (3) the occurrence of myocardial infarction or sudden unexpected death after a diagnosis of cerebral infarction. In patients in whom angina had been diagnosed, no significant difference was noted between the observed and the expected probability of stroke throughout 10 years of follow-up. In patients with a diagnosis of myocardial infarction, a significant difference was noted between observed and expected probabilities of stroke at 1 month and at 2 months. This early excess in probability of stroke was especially pronounced in the subgroup of patients with transmural myocardial infarction but not evident in those with subendocardial myocardial infarction. Among patients with a diagnosis of cerebral infarction, the difference between observed and expected probabilities of myocardial infarction or sudden unexpected death was not significant until 5 years after the cerebral infarction and showed no change thereafter.