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Association Between Heart Transplantation and Subsequent Risk of Stroke Among Patients With Heart Failure

Alexander E Merkler1,2, Monica L Chen1, Neal S Parikh1,3

  • 1From the Clinical and Translational Neuroscience Unit (A.E.M., M.L.C., N.S.P., S.B.M., B.B.N., C.I., H.K.).

Stroke
|February 13, 2019
PubMed

Insights

Heart transplantation significantly reduces stroke risk in heart failure patients awaiting the procedure. This study found a lower incidence of stroke after heart transplant compared to those still on the waiting list.

Area of Science:

  • Cardiology
  • Neurosurgery
  • Transplant Surgery

Background:

  • The impact of heart transplantation on stroke risk in heart failure patients remains unclear.
  • Heart failure patients awaiting transplantation face various health risks, including stroke.

Purpose of the Study:

  • To investigate if heart transplantation is linked to a reduced risk of subsequent stroke.
  • To analyze stroke incidence in heart failure patients before and after heart transplantation.

Main Methods:

  • Retrospective cohort study using administrative data (2005-2015) from NY, CA, and FL.
  • Identified heart failure patients awaiting transplantation, excluding those with prior stroke.
  • Used Cox proportional hazards analysis to assess the association between heart transplantation and stroke, adjusting for confounders.

Main Results:

  • 1068 of 7848 (13.6%) patients underwent heart transplantation.
  • Annual stroke incidence was 0.7% post-transplant versus 2.4% for those awaiting transplant.
  • Heart transplantation was associated with a 60% lower risk of stroke (HR, 0.4; 95% CI, 0.2-0.6).

Conclusions:

  • Heart transplantation is associated with a decreased risk of stroke.
  • This finding supports the benefit of heart transplantation in mitigating stroke risk for eligible patients.

Keywords:
comorbiditiesheart failureheart transplantationincidencerisk factor

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