Some Heart Attack Patients Without AFib Still at Increased Risk of Stroke Interview with:

Normal rhythm tracing (top) Atrial fibrillation (bottom) Wikipedia image

Normal rhythm tracing (top) Atrial fibrillation (bottom)
Wikipedia image

João Pedro Ferreira, MD, PhD &
Faiez Zannad, MD, PhD
National Institute of Health and Medical Research (INSERM)Center for Clinical Multidisciplinary Research 1433INSERM U1116University of LorraineRegional University Hospital of NancyFrench Clinical Research Infrastructure Network (F-CRIN) Investigation Network Initiative–Cardiovascular and Renal Clinical Trialists, Nancy, France
Department of Physiology and Cardiothoracic SurgeryCardiovascular Research and Development UnitFaculty of MedicineUniversity of Porto, Porto, Portugal What is the background for this study? What are the main findings?

Response: It is uncertain whether patients with a myocardial infarction with systolic dysfunction but without atrial fibrillation have increased risk for stroke.

In this study including >22,000 patients and 600 stroke events we found a subgroup of patients at high risk for stroke despite not having atrial fibrillation. These patients are older, have worse renal function, frank signs of pulmonary congestion, hypertension and previous stroke history. We created a simple and “ready to use” score that allows the identification of these patients in routine clinical practice. What should readers take away from your report? 

Response: The reader should be aware that some patients with complicated myocardial infarction may have high risk for stroke despite not having atrial fibrillation. The risk factors identified herein could be used in future studies to target stroke prevention strategies in patients at greatest risk following a myocardial infarction. What recommendations do you have for future research as a result of this work?

Response: This population should be targeted in future trial with non-VKA anticoagulants. One of the ongoing trials is the COMMANDER-HF (NCT01877915) with Pr Faiez Zannad as principal investigator.

No disclosures


Stroke Risk in Patients With Reduced Ejection Fraction After Myocardial Infarction Without Atrial Fibrillation
João Pedro FerreiraNicolas GirerdJohn GregsonIchraq LatarAbhinav SharmaMarc A. PfefferJohn J.V. McMurrayAzmil H. Abdul-RahimBertram PittKenneth DicksteinPatrick RossignolFaiez Zannad and for the High-Risk Myocardial Infarction Database Initiative

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Last Updated on February 13, 2018 by Marie Benz MD FAAD