Cardiac dysfunction after acute ischaemic stroke: Long-term outcomes from the SICFAIL cohort

Area of Science:

• Cardiology
• Neurology
• Public Health

Background:

• Acute ischemic stroke frequently leads to systolic dysfunction, diastolic dysfunction, and heart failure.
• These cardiac conditions are common post-stroke complications requiring further investigation.

Purpose of the Study:

• To determine if distinct cardiac phenotypes (systolic dysfunction, diastolic dysfunction, heart failure) after ischemic stroke are associated with 2-year readmission or death.
• To identify patients who may benefit from intensified cardiac follow-up and secondary prevention strategies.

Main Methods:

• Prospective cohort study (SICFAIL) enrolled adults with acute ischemic stroke.
• Cardiac function assessed at baseline; patients followed for 2 years for readmission or death.
• Multivariable Cox proportional hazards models used to estimate associations.

Main Results:

• Systolic dysfunction (HR 1.97) and clinically overt heart failure (HR 1.62) independently predicted a composite of readmission or death.
• Systolic dysfunction also predicted cardiovascular readmissions (HR 2.27).
• Isolated diastolic dysfunction was not associated with adverse outcomes.

Conclusions:

• Systolic dysfunction and overt heart failure post-ischemic stroke are independent predictors of 2-year adverse outcomes.
• Routine echocardiography after stroke can identify high-risk patients for targeted cardiac care.