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Published on: February 16, 2011
Heart failure in acute ischemic stroke
Angel Ois1, Meritxell Gomis, Elisa Cuadrado-Godia
1Unit of Neurovascular Research, Neurology Department, Institut Municipal d'Investigació Mèdica - Hospital del Mar, Departament de Medicina, Universitat Autònoma de Barcelona, Spain. 94545@imas.imim.es
Insights
Heart failure (HF) in acute ischemic stroke (AIS) patients, whether with preserved or decreased left ventricular function, independently predicts a poor outcome. This includes moderate-severe disability or death within 90 days.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Acute ischemic stroke (AIS) poses significant health challenges.
- Heart failure (HF) is a common comorbidity in AIS patients.
- The impact of different HF types on AIS outcomes requires clarification.
Purpose of the Study:
- To investigate the association between heart failure (HF) with preserved or decreased left ventricular function (LVF) and outcomes in acute ischemic stroke (AIS) patients.
- To determine if HF impacts stroke severity and mortality.
- To analyze risk factors associated with poor outcomes in AIS patients with HF.
Main Methods:
- A cohort of 503 unselected AIS patients was studied.
- Poor outcome was defined as moderate-severe disability or death at 90 days post-stroke.
- Logistic regression analysis was employed to assess the association between HF types and poor outcomes, adjusting for confounders.
Main Results:
- 17.7% of patients had HF (9.7% systolic HF, 8% HF with preserved LVF).
- Patients with HF and preserved LVF were older, more likely female, and less likely to smoke compared to those with systolic HF.
- An independent association was found between initial stroke severity, systolic HF (aOR=3.01), HF with preserved LVF (aOR=2.52), and poor outcome.
Conclusions:
- Both systolic heart failure and heart failure with preserved left ventricular function are independently associated with poor outcomes in acute ischemic stroke patients.
- These findings highlight the importance of managing HF in AIS patients to improve prognoses.
- Further research may explore specific interventions for HF patients experiencing AIS.
Background:
To determine the impact of heart failure (HF), with preserved or decreased left ventricular function (LVF), on outcome in patients with acute ischemic stroke (AIS).
Methods:
We studied 503 unselected ischemic stroke patients. Poor outcome was defined as moderate-severe disability or death at 90 days. We analyzed the association between poor outcome and HF with preserved LVF or decreased LVF (systolic HF: ejection fraction lower than 50%). We tested this association adjusted by possible confounders in a logistic regression model.
Results:
89 patients (17.7 %) had HF; 49 patients (9.7%) with systolic HF, and 40 (8%) patients with HF and preserved LVF. HF with preserved LVF patients were older [79.4 (7.9) vs. 74.3 (10.4), p = 0.013],more likely to be women [p < 0.001,OR = 8.61, 95% CI (3.3-22.6)], and with lower current smoking habits [p = 0.018, OR = 8.77 (1.1-72.6)] than patients with systolic HF. 151 patients (30 %) had poor outcome. We found an independent association with initial stroke severity, systolic HF (adjusted OR = 3.01), HF with preserved LVF (adjusted OR = 2.52), thrombolytic treatment, statin pre-treatment (as protectors) and poor outcome.
Conclusion:
Both forms of HF (with or without decreased systolic function) are associated with poor outcome in AIS.
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