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Poor functional status based on the New York Heart Association classification exposes the coronary patient to an

Nira Koren-Morag1, Uri Goldbourt, David Tanne

  • 1Division of Epidemiology, Sackler Medical Faculty, Tel Aviv University, Tel Aviv, Israel.

American Heart Journal
|February 26, 2008
PubMed

Insights

Patients with coronary heart disease (CHD) face higher stroke risks. Even slight limitations in New York Heart Association (NYHA) functional class significantly increase the likelihood of ischemic stroke.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Coronary heart disease (CHD) patients exhibit elevated risks for cerebrovascular events, particularly ischemic stroke.
  • The New York Heart Association (NYHA) functional classification system assesses cardiac patient functional status.
  • Understanding the link between functional status and stroke incidence is crucial for risk stratification in CHD populations.

Purpose of the Study:

  • To examine the association between NYHA functional classification and the incidence of ischemic stroke in a large cohort of CHD patients.
  • To determine if functional limitations, as defined by NYHA classes, predict future ischemic stroke events.

Main Methods:

  • A prospective cohort study followed 15,524 patients with documented CHD for 4.8 to 8.1 years.
  • Functional status was assessed using the NYHA classification at baseline.
  • Cox proportional hazard models were employed to analyze the relationship between NYHA class and ischemic stroke, adjusting for multiple cardiovascular risk factors.

Main Results:

  • Among 14,703 eligible patients, 604 (4.1%) experienced ischemic stroke or transient ischemic attack.
  • The cumulative incidence of ischemic cerebrovascular events rose with increasing NYHA functional class (Class I: 6.7%, Class II: 9.2%, Class III: 9.7%).
  • Adjusted analyses revealed significantly higher risks for NYHA Class II (HR 1.29) and Class III (HR 1.71) compared to Class I.

Conclusions:

  • Functional status, as indicated by NYHA classification, is a significant independent predictor of ischemic stroke risk in CHD patients.
  • Even mild functional limitations (NYHA Class II) are associated with a notably increased risk of ischemic stroke.
  • These findings underscore the importance of assessing functional status in CHD management for stroke risk prediction.
Abstract

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