Acute Ischemic Stroke, Depressed Left Ventricular Ejection Fraction, and Sinus Rhythm: Prevalence and Practice...

Area of Science:

• Cardiology
• Neurology
• Epidemiology

Background:

• Limited data exist on secondary stroke prevention for patients with acute ischemic stroke (AIS), depressed left ventricular ejection fraction (LVEF), and sinus rhythm.
• Understanding the prevalence of LVEF ≤40% and sinus rhythm in AIS patients is crucial for developing effective treatment strategies.

Purpose of the Study:

• To determine the prevalence of LVEF ≤40% and sinus rhythm in patients experiencing AIS.
• To describe antithrombotic treatment practices for this patient group in a multi-center cohort.

Main Methods:

• A multi-center, retrospective cohort study involving patients hospitalized with AIS.
• A meta-analysis of proportions was used to calculate pooled prevalence.
• Logistic regression identified factors associated with anticoagulant prescription at discharge.

Main Results:

• The pooled prevalence of LVEF ≤40% and sinus rhythm among AIS patients was 5.0%.
• Among eligible patients, 38% were discharged on anticoagulants, 55% on antiplatelet therapy only, and 7% on neither.
• Hospital site and stroke severity (NIHSS > 8) independently predicted anticoagulant use.

Conclusions:

• Approximately 5% of AIS patients present with reduced LVEF and sinus rhythm.
• Significant variations in antithrombotic therapy prescription exist across clinical sites and are influenced by stroke severity.
• Further research is required to establish optimal antithrombotic regimens for secondary stroke prevention in this population.