{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T20:31:26Z","timestamp":1770755486723,"version":"3.50.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,1,17]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Acute myocardial infarction (AMI) infrequently occurs after acute stroke. The Heart\u2010brain team approach has a potential to appropriately manage this poststroke cardiovascular complication. However, clinical outcomes of AMI complicating acute stroke (AMI\u2010CAS) with the heart\u2010brain team approach have not been characterized. The current study investigated cardiovascular outcomes in patients with AMI\u2010CAS managed by a heart\u2010brain team.<\/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              We retrospectively analyzed 2390 patients with AMI at our institute (January 1, 2007\u2013September 30, 2020). AMI\u2010CAS was defined as the occurrence of AMI within 14\u2009days after acute stroke. Major adverse cerebral\/cardiovascular events (cardiac\u2010cause death, nonfatal myocardial infarction, and nonfatal stroke) and major bleeding events were compared in subjects with \u00a0AMI\u2010CAS and those without acute stroke. AMI\u2010CAS was identified in 1.6% of the subjects. Most AMI\u2010CASs (37\/39=94.9%) presented ischemic stroke. Median duration of AMI from the onset of acute stroke was 2\u2009days. Patients with AMI\u2010CAS less frequently received primary percutaneous coronary intervention (43.6% versus 84.7%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and dual\u2010antiplatelet therapy (38.5% versus 85.7%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and 33.3% of them did not receive any antithrombotic agents (versus 1.3%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). During the observational period (median, 2.4\u2009years [interquartile range, 1.1\u20134.4\u2009years]), patients with AMI\u2010CAS exhibited a greater likelihood of experiencing major adverse cerebral\/cardiovascular events (hazard ratio [HR], 3.47 [95% CI, 1.99\u20136.05];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and major bleeding events (HR, 3.30 [95% CI, 1.34\u20138.10];\n              <jats:italic>P<\/jats:italic>\n              =0.009). These relationships still existed even after adjusting for clinical characteristics and medication use (major adverse cerebral\/cardiovascular event: HR, 1.87 [95% CI, 1.02\u20133.42];\n              <jats:italic>P<\/jats:italic>\n              =0.04; major bleeding: HR, 2.67 [95% CI, 1.03\u20136.93];\n              <jats:italic>P<\/jats:italic>\n              =0.04).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Under the heart\u2010brain team approach, AMI\u2010CAS was still a challenging disease, reflected by less adoption of primary percutaneous coronary intervention and antithrombotic therapies, with substantially elevated cardiovascular and major bleeding risks. Our findings underscore the need for a further refined approach to mitigate their ischemic\/bleeding risks.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.027156","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T11:19:36Z","timestamp":1673867976000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Heart\u2010Brain Team Approach of Acute Myocardial Infarction Complicating Acute Stroke: Characteristics of Guideline\u2010Recommended Coronary Revascularization and Antithrombotic Therapy and Cardiovascular and Bleeding Outcomes"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9386-2432","authenticated-orcid":false,"given":"Toshiaki","family":"Suzuki","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita, Osaka Japan"},{"name":"Department of Advanced 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