Myocardial infarction survivors have a 44-fold increased risk for stroke in the 30 days following the myocardial infarction, and the level of risk for stroke seems to remain elevated for at least several years, according to an article in the December 6 issue of the Annals of Internal Medicine.

“While our research reaffirmed the risk of stroke among patients with heart disease, the surprise was that the risk was so high in the month after a heart attack,” said Veronique Roger, MD, MPH, the Mayo Clinic cardiologist who was senior author of the study.

“A lot of patients survive heart attacks today, which is why this study is so relevant,” she added. “It emphasizes the importance of worrying about other things that can happen beyond heart attacks, stroke being one of them.”

The American researchers reviewed the medical records of 2,160 patients who received care for a myocardial infarction at the Mayo Clinic in Rochester, Minn., between 1979 and 1998 to see whether the patients had a stroke and/or died after the infarction. Most patients were followed for about six years.

In addition to the high risk in the first 30 days, stroke risk remained two to three times higher than expected during the first three years following the myocardial infarction. Older age, previous stroke and diabetes increased the risk for stroke, Roger said.

In addition, strokes were associated with a large increase in the risk for death after the myocardial infarction, she said.

Researchers also discovered that the risk of stroke did not change over time. In the 20 years studied, the risk of stroke did not decrease over that period, Dr. Roger says.

Further studies will help define what can specifically be done to prevent strokes after myocardial infarction, concluded the authors.