Jitphapa Pongmoragot1, Douglas S Lee2, Tai Hwan Park3, Jiming Fang4, Peter C Austin4, Gustavo Saposnik5. 1. Stroke Outcomes Research Center, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. 2. Peter Munk Cardiac Centre, Joint Department of Medical Imaging, Institute for Clinical Evaluative Science, IHPME, University Health Network, Toronto, Ontario, Canada. 3. Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea. 4. Department of Statistics, Institute of Clinical Evaluative Sciences (ICES), Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada. 5. Stroke Outcomes Research Center, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. Electronic address: saposnikg@smh.ca.
Abstract
BACKGROUND AND OBJECTIVES: Limited information is known regarding acute ischemic stroke (AIS) and heart failure (HF). The aim of the study was to evaluate clinical characteristics, predisposing factors, and outcomes in AIS with HF. METHODS: We included AIS patients admitted to the institutions participating in the Registry of the Canadian Stroke Network. HF was defined as history of pre-existing HF or pulmonary edema present at the time of arrival. The primary outcome was death or disability at discharge (modified Rankin Scale score >3). Secondary outcomes included disposition, death at 3 months and at 1 year, and 30-day hospital readmissions. RESULTS: Among 12,396 patients, HF was found in 1124 (9.1%) patients. HF was associated with higher risk of death at 30 days (24.5% versus 11.2%, P < .0001), at 1 year (44.3% versus 20.6, P < .0001), and disability at discharge (70.4% versus 56%, P < .0001). In the multivariable analysis, HF was an independent predictor of death and disability (odds ratio 1.18, 95% confidence interval [CI] 1.01-1.37), death at 30 days (hazard ratio [HR] 1.22, 95% CI 1.05-1.41), and hospital readmissions (HR 1.32, 95% CI 1.05-1.65) at 30 days. The results were unaltered when adjusting for pneumonia with the exception of death or disability at discharge. CONCLUSIONS: In this large cohort study, HF was observed in 9.1% of AIS patients. HF is an independent predictor of death and disability and hospital readmissions after stroke at 30 days.
BACKGROUND AND OBJECTIVES: Limited information is known regarding acute ischemic stroke (AIS) and heart failure (HF). The aim of the study was to evaluate clinical characteristics, predisposing factors, and outcomes in AIS with HF. METHODS: We included AISpatients admitted to the institutions participating in the Registry of the Canadian Stroke Network. HF was defined as history of pre-existing HF or pulmonary edema present at the time of arrival. The primary outcome was death or disability at discharge (modified Rankin Scale score >3). Secondary outcomes included disposition, death at 3 months and at 1 year, and 30-day hospital readmissions. RESULTS: Among 12,396 patients, HF was found in 1124 (9.1%) patients. HF was associated with higher risk of death at 30 days (24.5% versus 11.2%, P < .0001), at 1 year (44.3% versus 20.6, P < .0001), and disability at discharge (70.4% versus 56%, P < .0001). In the multivariable analysis, HF was an independent predictor of death and disability (odds ratio 1.18, 95% confidence interval [CI] 1.01-1.37), death at 30 days (hazard ratio [HR] 1.22, 95% CI 1.05-1.41), and hospital readmissions (HR 1.32, 95% CI 1.05-1.65) at 30 days. The results were unaltered when adjusting for pneumonia with the exception of death or disability at discharge. CONCLUSIONS: In this large cohort study, HF was observed in 9.1% of AISpatients. HF is an independent predictor of death and disability and hospital readmissions after stroke at 30 days.
Authors: Tiberiu A Pana; Adrian D Wood; Jesus A Perdomo-Lampignano; Somsak Tiamkao; Allan B Clark; Kannikar Kongbunkiat; Joao H Bettencourt-Silva; Kittisak Sawanyawisuth; Narongrit Kasemsap; Mamas A Mamas; Phyo K Myint Journal: Heart Asia Date: 2019-04-20
Authors: Chantal F Ski; Martje H L van der Wal; Michael Le Grande; Dirk J van Veldhuisen; Ivonne Lesman-Leegte; David R Thompson; Sandy Middleton; Jan Cameron; Tiny Jaarsma Journal: BMJ Open Date: 2019-08-27 Impact factor: 2.692