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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
Summary
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.
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