Stroke Events in Patients with Non-ST Elevation Acute Coronary Syndromes in China

Objective To analyze the characteristics of stroke events in patients with non-ST elevation acute coronary syndromes during two years of follow-up in China and the relationship between stroke events and multiple risk factors. Methods This study was a part of an international multicenter registry organization to assess strategies for ischemic syndromes (OASIS). All patients had been followed up for two years. The patients' clinical characteristics, therapeutic and major events during hospitalization and two years' follow up period were compared between stroke and non-stroke patients. Cox regression model was used to analyze the association between stroke and multiple factors recorded, including baseline characteristics, previous medical history and therapeutic. Results Among the registered 2294 NSTE-ACS patients in China, 93(4.2%) had stroke events during 2 years follow up period, of which 80% were ischemic stroke. Mean age of stroke patients was 67.6±9.6 years higher than 62.6±10.4 years in patients without stroke(P0.01,95% CI:2.837-7.138). Mean systolic blood pressure was 147.4±25.2 mm Hg in stroke patients, also higher than 138.1±24.2 mm Hg in patients without stroke(P0.01, 95% CI:4.276-14.346). Previous history of stroke and hypertension were more common in patients with stroke(P0.01). Total mortality of patients with stroke were much higher than that of non-stroke patients(P0.01). Cox regression showed major risk factors that predisposed to stroke were history of stroke(RR=2.329, 95% CI:1.343-4.041), sustained chest pain at admission (RR=1.957, 95%CI:1.261-3.037), history of hypertension (RR=1.848, 95% CI:1.153-2.963), re-hospitalization during follow-up period (RR=1.823, 95%CI:1.122-2.960) and age (RR=1.056, 95%CI:1.031-1.081). Protective factors that reduced stroke were the frequency of using nitrate during follow-up period (RR=0.803, 95% CI: 0.665-0.969), using of nitrate before admission (RR=0.537, 95% CI: 0.346-0.834). Conclusions Non-ST segment elevation ACS patients with stroke had higher mortality. Previous history of stroke, sustained chest pain at admission, history of hypertension, older age were risk factors for stroke in patients with non-ST segment elevation ACS.