Kasper Adelborg1, Szimonetta Szépligeti2, Jens Sundbøll2, Erzsébet Horváth-Puhó2, Victor W Henderson2, Anne Ording2, Lars Pedersen2, Henrik Toft Sørensen2. 1. From the Department of Clinical Epidemiology, Aarhus University Hospital, Denmark (K.A., S.S., J.S., E.H.-P., V.W.H., A.O., L.P., H.T.S.); and Department of Health Research and Policy (Epidemiology) (V.W.H., H.T.S.) and Department of Neurology and Neurological Sciences (V.W.H.), Stanford University, CA. kade@clin.au.dk. 2. From the Department of Clinical Epidemiology, Aarhus University Hospital, Denmark (K.A., S.S., J.S., E.H.-P., V.W.H., A.O., L.P., H.T.S.); and Department of Health Research and Policy (Epidemiology) (V.W.H., H.T.S.) and Department of Neurology and Neurological Sciences (V.W.H.), Stanford University, CA.
Abstract
BACKGROUND AND PURPOSE: The long-term risk of specific stroke subtypes among heart failure patients is largely unknown. We examined short-term and long-term risk of ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in heart failure patients and in a general population comparison cohort. METHODS: In this nationwide cohort study (1980-2012), we used Danish population-based medical registries to identify and follow (1) all patients hospitalized for the first time with heart failure and (2) a birth year-, sex-, and calendar year-matched general population comparison cohort. Age-, sex-, and comorbidity-adjusted stroke rate ratios were computed based on Cox regression analysis. RESULTS: We included 289 353 patients with heart failure and 1 446 765 individuals from the general population in the analysis. One- and 5-year risks among heart failure patients were 1.4% and 3.9% for ischemic stroke, 0.2% and 0.5% for ICH, and 0.03% and 0.07% for SAH. The 30-day adjusted stroke rate ratio was increased markedly for ischemic stroke (5.08; 95% confidence interval, 4.58-5.63] and was also elevated for ICH (2.13; 95% confidence interval, 1.53-2.97) and SAH (3.52; 95% confidence interval, 1.54-8.08). Between 31 days and 30 years, risk of all stroke subtypes remained positively associated with heart failure (1.5- to 2.1-fold for ischemic stroke, 1.4- to 1.8-fold for ICH, and 1.1- to 1.7-fold for SAH) in comparison with the general population cohort. CONCLUSIONS: Heart failure was associated with increased short-term and long-term risk of all stroke subtypes, suggesting that heart failure is a potent and persistent risk factor for ischemic stroke, ICH, and SAH.
BACKGROUND AND PURPOSE: The long-term risk of specific stroke subtypes among heart failurepatients is largely unknown. We examined short-term and long-term risk of ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in heart failurepatients and in a general population comparison cohort. METHODS: In this nationwide cohort study (1980-2012), we used Danish population-based medical registries to identify and follow (1) all patients hospitalized for the first time with heart failure and (2) a birth year-, sex-, and calendar year-matched general population comparison cohort. Age-, sex-, and comorbidity-adjusted stroke rate ratios were computed based on Cox regression analysis. RESULTS: We included 289 353 patients with heart failure and 1 446 765 individuals from the general population in the analysis. One- and 5-year risks among heart failurepatients were 1.4% and 3.9% for ischemic stroke, 0.2% and 0.5% for ICH, and 0.03% and 0.07% for SAH. The 30-day adjusted stroke rate ratio was increased markedly for ischemic stroke (5.08; 95% confidence interval, 4.58-5.63] and was also elevated for ICH (2.13; 95% confidence interval, 1.53-2.97) and SAH (3.52; 95% confidence interval, 1.54-8.08). Between 31 days and 30 years, risk of all stroke subtypes remained positively associated with heart failure (1.5- to 2.1-fold for ischemic stroke, 1.4- to 1.8-fold for ICH, and 1.1- to 1.7-fold for SAH) in comparison with the general population cohort. CONCLUSIONS:Heart failure was associated with increased short-term and long-term risk of all stroke subtypes, suggesting that heart failure is a potent and persistent risk factor for ischemic stroke, ICH, and SAH.
Authors: Alexander E Merkler; Monica L Chen; Neal S Parikh; Santosh B Murthy; Shadi Yaghi; Parag Goyal; Peter M Okin; Maria G Karas; Babak B Navi; Costantino Iadecola; Hooman Kamel Journal: Stroke Date: 2019-03 Impact factor: 7.914
Authors: Mariam Elmegaard Malik; Charlotte Andersson; Paul Blanche; Maria D'Souza; Christian Madelaire; Bochra Zareini; Morten Lamberts; Søren Lund Kristensen; Naveed Sattar; John McMurray; Lars Køber; Christian Torp-Pedersen; Gunnar Gislason; Morten Schou Journal: Clin Res Cardiol Date: 2022-04-08 Impact factor: 5.460
Authors: Eric J Chow; Richard Aplenc; Lynda M Vrooman; David R Doody; Yuan-Shung V Huang; Sanjeev Aggarwal; Saro H Armenian; K Scott Baker; Smita Bhatia; Louis S Constine; David R Freyer; Lisa M Kopp; Wendy M Leisenring; Barbara L Asselin; Cindy L Schwartz; Steven E Lipshultz Journal: Cancer Date: 2021-10-13 Impact factor: 6.860
Authors: Niels Secher; Kasper Adelborg; Péter Szentkúti; Christian Fynbo Christiansen; Asger Granfeldt; Victor W Henderson; Henrik Toft Sørensen Journal: JAMA Netw Open Date: 2022-05-02
Authors: M Kruska; C Fastner; J F Scheitz; A Kolb; M Rutsch; T Papavassiliu; M Borggrefe; A Alonso; I Akin; K Szabo; S Baumann Journal: Herz Date: 2020-07-06 Impact factor: 1.443
Authors: Alec L E Butenas; Trenton D Colburn; Dryden R Baumfalk; Carl J Ade; K Sue Hageman; Steven W Copp; David C Poole; Timothy I Musch Journal: Respir Physiol Neurobiol Date: 2021-01-06 Impact factor: 1.931