Long-term survival of patients after cerebrovascular accident with prior coronary artery disease: data from the outpatient stage of REGION-M registry

Abstract

Aim. To study two-year survival and factors affecting it in patients with cerebrovascular accident (CVA) with prior coronary artery disease (CAD).Material and methods. The outpatient stage of the REGION-M registry included 684 patients assigned to the Moscow City Polyclinic № 64, discharged from the F.I. Inozemtsev City Clinical Hospital in the period from January 1, 2012 to April 30, 2017 with a verified diagnosis of stroke or transient ischemic attack. Of these, 423 (61,8%) patients had a diagnosis of CAD in the outpatient records.Results. Patients with CAD were significantly older, more often had comorbidities, disability, and were monitored in the polyclinic before the stroke and after hospital discharge than patients without CAD. During the follow-up period, mortality among patients with CAD (34,3%) was significantly higher than without CAD (19,9%) (p< 0,01), At the same time, mortality in CAD was 2,6 times lower among patients who applied to the polyclinic at least once after discharge (28%) than those who never applied after discharge — 72,9% (p< 0,001), Multivariate analysis confirmed this positive effect (relative risk, 0,998; confidence interval: 0,983-0,992, p< 0,0001).Conclusion. Mortality in patients with stroke and CAD was significantly higher than in those without CAD, while it was significantly lower among patients monitored in the polyclinic in the post-hospital period of stroke.

Keywords

• cerebral stroke
• coronary artery disease
• registry
• longterm survival
• mortality
• polyclinic visits
• medical supervision