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Long-term prognosis of combined chronic heart failure and chronic renal dysfunction after acute stroke

George Tsagalis1, Neratzoula Bakirtzi, Konstantinos Spengos

  • 1Renal Unit, Alexandra Hospital, Athens, Greece. tsagalis@otenet.gr

European Journal of Heart Failure
|April 24, 2010
PubMed

Insights

Patients with chronic heart failure and chronic renal dysfunction (CHF-CRD) after acute stroke face significantly higher long-term mortality and cardiovascular risks. This combined condition is a critical independent predictor of adverse outcomes over a decade.

Area of Science:

  • Cardiology
  • Nephrology
  • Neurology
  • Clinical Epidemiology

Background:

  • Acute stroke patients often present with pre-existing comorbidities.
  • Chronic heart failure (CHF) and chronic renal dysfunction (CRD) are common conditions that can coexist.
  • The combined impact of CHF and CRD on long-term outcomes following acute stroke is not well-established.

Purpose of the Study:

  • To determine the prevalence of combined CHF and CRD in patients experiencing acute stroke.
  • To evaluate the prognostic significance of CHF-CRD on long-term mortality and cardiovascular morbidity after acute stroke.

Main Methods:

  • A cohort of 831 first-ever acute stroke patients was analyzed, excluding those with acute kidney injury or decompensated heart failure.
  • Patients were categorized into four groups: no CHF/CRD, CRD only, CHF only, and combined CHF-CRD.
  • Long-term outcomes, including all-cause mortality and new cardiovascular events over 10 years, were assessed using survival analysis.

Main Results:

  • Both CHF and CRD were independently associated with increased 10-year mortality.
  • Patients with CHF-CRD exhibited the highest mortality risk (HR 3.42) compared to those without either condition.
  • Combined CHF-CRD also independently predicted new cardiovascular events (HR 3.59), with significant risks also observed for CHF-only and CRD-only groups.

Conclusions:

  • The presence of combined chronic heart failure and chronic renal dysfunction (CHF-CRD) following an acute stroke is a significant independent predictor of mortality.
  • CHF-CRD also independently predicts increased cardiovascular morbidity over a 10-year follow-up period.
  • These findings highlight the critical prognostic importance of managing coexisting CHF and CRD in acute stroke survivors.
Abstract

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