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Heart Failure and Stroke

Katja Schumacher1,2, Jelena Kornej2,3, Eduard Shantsila1

  • 1Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.

Current Heart Failure Reports
|August 1, 2018
PubMed

Insights

Heart failure (HF) patients face a high risk of ischemic stroke, especially with atrial fibrillation (AF). The CHA₂DS₂-VASc score may help stratify stroke risk in HF patients, guiding prevention strategies.

Area of Science:

  • Cardiology
  • Neurology
  • Internal Medicine

Background:

  • Ischemic stroke is a major cause of death and disability in heart failure (HF) patients.
  • The presence of atrial fibrillation (AF) significantly elevates stroke risk in HF.
  • Asymptomatic (silent) AF paroxysms complicate risk stratification in HF patients.

Purpose of the Study:

  • To review stroke risk in heart failure patients.
  • To discuss risk stratification methods for stroke in HF.
  • To outline stroke prevention strategies for HF patients.

Main Methods:

  • Review of current literature on stroke risk in heart failure.
  • Analysis of the utility of the CHA₂DS₂-VASc score in HF patients.
  • Examination of independent risk factors for stroke in HF.

Main Results:

  • The CHA₂DS₂-VASc score shows predictive value for stroke in HF patients, irrespective of AF.
  • Hypertension, diabetes mellitus, and prior stroke are identified independent risk factors.
  • Heart failure itself is an independent risk factor for stroke.
  • Oral anticoagulation is recommended for HF patients with AF.
  • Individualized risk stratification is preferred for HF patients without AF.

Conclusions:

  • The CHA₂DS₂-VASc score may aid in routine stroke risk prediction for HF patients with or without AF.
  • Current guidelines favor non-vitamin K antagonist anticoagulants over warfarin.
  • Further research may refine stroke prevention strategies in HF populations.
Abstract

Keywords:
Heart failureRisk stratificationSilent atrial fibrillationStrokeStroke prevention

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