{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:18:31Z","timestamp":1790849911584,"version":"4.1.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,7,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Prior studies show an increased risk of ischemic stroke (\n              <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>\n              ) after myocardial infarction; however, there is limited evidence on long\u2010term risk and whether it is directly related to cardiac injury. We hypothesized that the risk of\n              <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>\n              after acute coronary syndrome is significantly higher if there is evidence of cardiac injury, such as ST\u2010segment elevation myocardial infarction (\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              ) or non\u2010\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              , than when there is no evidence of cardiac injury, such as in unstable angina.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Administrative claims data were obtained from all emergency department encounters and hospitalizations at California's nonfederal acute care hospitals between 2008 and 2011. Patients with\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              , non\u2010STEMI, and unstable angina were identified using appropriate International Classification of Diseases, Ninth Revision, Clinical Modification codes. The primary outcome was\n              <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>\n              during 2\u00a0years of follow\u2010up. Unadjusted and adjusted Cox proportional hazards models were used to determine the association between acute coronary syndrome subtype and\n              <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>\n              risk. We identified 73\u00a0059 patients with a diagnosis of\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              (n=26\u00a0427), non\u2010STEMI (n=39\u00a0833), or unstable angina (n=6819) during the study period. In the fully adjusted models that included potential confounders such as atrial fibrillation and congestive heart failure, the risk of IS was higher with\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              (hazard ratio 4.17, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              3.00\u20135.83;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and non\u2010STEMI (hazard ratio 3.73, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              2.68\u20135.19,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) compared with unstable angina.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Non\u2010STEMI and\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              confer an equally increased risk of\n              <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>\n              . Studies exploring IS mechanisms in cardiac patients are needed to improve and tailor stroke prevention strategies.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.002590","type":"journal-article","created":{"date-parts":[[2016,7,14]],"date-time":"2016-07-14T05:57:19Z","timestamp":1468475839000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Ischemic Stroke Risk After Acute Coronary Syndrome"],"prefix":"10.1161","volume":"5","author":[{"given":"Shadi","family":"Yaghi","sequence":"first","affiliation":[{"name":"Division of Stroke and Cerebrovascular Diseases, Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markeith","family":"Pilot","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Loma Linda University, Loma Linda, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, The Warren Alpert Medical School of Brown University,  Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina A.","family":"Blum","sequence":"additional","affiliation":[{"name":"Division of Stroke and Cerebrovascular Diseases, Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Yakhkind","sequence":"additional","affiliation":[{"name":"Division of Stroke and Cerebrovascular Diseases, Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Silver","sequence":"additional","affiliation":[{"name":"Division of Stroke and Cerebrovascular Diseases, Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen L.","family":"Furie","sequence":"additional","affiliation":[{"name":"Division of Stroke and Cerebrovascular Diseases, Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell S. V.","family":"Elkind","sequence":"additional","affiliation":[{"name":"Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY"},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Sherzai","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha Z.","family":"Sherzai","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.4.762"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(89)90341-0"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90409-T"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.005770"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00258-1"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198902093200604"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000230607.07928.17"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2010.03781.x"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.9143"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-002155"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.07.030"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000032240.28636.BD"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)07349-3"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200106213442501"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs314"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00003-4"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00392-5"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.1998.0871"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.011273"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24482"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.001118"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.006364"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.000173"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.004712"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.008711"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.115.002590","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:12:04Z","timestamp":1715595124000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.115.002590"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,6]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,7,6]]}},"alternative-id":["10.1161\/JAHA.115.002590"],"URL":"https:\/\/doi.org\/10.1161\/jaha.115.002590","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,6]]},"assertion":[{"value":"2016-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-05-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e002590"}}