Stroke and neck artery tear increase heart attack risk in the first year

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The risk of a heart attack nearly doubles in the first year after a stroke or when there is a tear in the wall of an artery in the neck, however, a tear without a stroke does not appear to increase the risk of a heart attack, according to preliminary research presented at the American Stroke Association’s International Stroke Conference 2024. The meeting will be held in Phoenix, Feb. 7-9, and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

“Our findings may help clinicians assess and manage cardiovascular risk after these events.”


Likki Shu, MD, Clinical Fellow in Neurology, Warren Alpert Medical School at Brown University in Providence, Rhode Island

Aortic dissection is a tear in the wall of the aorta, the large artery that receives blood directly from the heart, and it increases the risk of heart attack. A tear in the wall of the carotid or vertebral artery, which extends from the aorta and carries blood through the neck to the brain, is called a carotid or vertebral artery dissection. This dissection can lead to stroke and strokes are known to be associated with heart attacks. Before this study it was unclear whether carotid or vertebral artery dissection itself increased the risk of heart attack.

Researchers analyzed health data on more than 800,000 adults (mean age 63 years; 62% female) hospitalized in New York (between 2011 and 2017) or Florida (between 2011-2019). Patients with no history of recent major head or neck injury were divided into four groups based on diagnosis: acute ischemic stroke; Cervical artery dissection; A reference group consisted of patients with both or transient ischemic attack called “alert stroke”, temporary loss of short-term memory (transient global amnesia) or migraine.

After adjusting for heart attack risk factors, the study found:

  • Patients who underwent carotid or vertebral artery dissection without stroke had a risk of heart attack within one year similar to patients in the reference group.
  • Stroke patients, with or without carotid or vertebral artery dissection, were almost twice as likely to have a heart attack within one year compared to patients in the reference group.

“Previously, this was only a hypothesis, but now we know that carotid or vertebral artery dissection does not cause a stroke, does not increase the risk of heart attack, and this suggests that physicians should mainly focus on stroke prevention in this subgroup of patients. Shu Dr.

Study Background:

  • Participants with a recent history of major head or neck injury were excluded. Head or neck trauma can lead to traumatic carotid dissection, which differs from this study’s focus on spontaneous dissection.
  • The analysis controlled for various heart attack risk factors, including age, type 1 or type 2 diabetes, heart failure, coronary artery disease, high cholesterol and high blood pressure.

  • About 20,000 participants experienced a heart attack within a year of their initial hospitalization, and heart attack risk was compared between diagnostic groups.
  • Of the survey group of 823,634 participants, 65.4% were white, 16.2% were black or African American, and 12.2% were Hispanic or Latino adults.

Although this study is based on hospitalization data only in New York and Florida, it is important to note that these states collectively represent a significant portion of the US population, more than 10% of the total. These two states also provide a good representation of different demographic groups, adding strength to the results. However, caution should still be exercised when generalizing these findings to people living in other geographic regions. In addition, this retrospective analysis (looking back in time to analyze data) may not account for all factors influencing heart attack risk, such as drug use, which were not included in the database.

According to the American Heart Association’s Heart Disease and Stroke Statistics 2024 Update, stroke accounted for nearly 1 of every 21 deaths in the United States in 2021.



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