Trushil G Shah1, Jaini M Sutaria2, Manav V Vyas3. 1. Division of Pulmonary and Critical Care Medicine, UT Southwestern, Dallas, TX, USA. 2. Parkland Health and Hospital System, Department of Internal Medicine, UT Southwestern, Dallas, TX, USA. 3. Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: manav.vyas@mail.utoronto.ca.
Abstract
BACKGROUND: Pulmonary hypertension is associated with atrial fibrillation and paradoxical embolism. Yet, the association between pulmonary hypertension and stroke has not been well studied. METHODS: We reviewed Medline and Embase from inception to December 1, 2018, to identify observational studies reporting prevalence of stroke in adult patients with pulmonary hypertension. We sought studies that included patients with pulmonary hypertension secondary to any etiology except left heart failure, and excluded studies that reported rates of perioperative stroke. We conducted random effects meta-analyses to obtain pooled prevalence of stroke in patients with pulmonary hypertension, and pooled unadjusted odds ratio of stroke in patients with pulmonary hypertension compared to those without. RESULTS: We included 14 studies including 32,523 participants of which 2976 (9.2%) had pulmonary hypertension, and 727 (2.2%) had a stroke. The pooled prevalence of stroke in patients with pulmonary hypertension was 8.0% [95% confidence interval (CI), 5.1%-10.9%, I2 91.9]. The pooled unadjusted odds ratio of stroke in patients with pulmonary hypertension compared to those without was 1.46 (95% CI, 1.07-1.99, I2 55.6, n = 7 studies). CONCLUSION: Stroke is a major non-cardiac morbidity in patients with pulmonary hypertension, requiring further evaluation to determine its etiology, and measures to reduce its risk.
BACKGROUND:Pulmonary hypertension is associated with atrial fibrillation and paradoxical embolism. Yet, the association between pulmonary hypertension and stroke has not been well studied. METHODS: We reviewed Medline and Embase from inception to December 1, 2018, to identify observational studies reporting prevalence of stroke in adult patients with pulmonary hypertension. We sought studies that included patients with pulmonary hypertension secondary to any etiology except left heart failure, and excluded studies that reported rates of perioperative stroke. We conducted random effects meta-analyses to obtain pooled prevalence of stroke in patients with pulmonary hypertension, and pooled unadjusted odds ratio of stroke in patients with pulmonary hypertension compared to those without. RESULTS: We included 14 studies including 32,523 participants of which 2976 (9.2%) had pulmonary hypertension, and 727 (2.2%) had a stroke. The pooled prevalence of stroke in patients with pulmonary hypertension was 8.0% [95% confidence interval (CI), 5.1%-10.9%, I2 91.9]. The pooled unadjusted odds ratio of stroke in patients with pulmonary hypertension compared to those without was 1.46 (95% CI, 1.07-1.99, I2 55.6, n = 7 studies). CONCLUSION:Stroke is a major non-cardiac morbidity in patients with pulmonary hypertension, requiring further evaluation to determine its etiology, and measures to reduce its risk.
Authors: Tiberiu A Pana; Dana K Dawson; Mohamed O Mohamed; Fiona Murray; David L Fischman; Michael P Savage; Mamas A Mamas; Phyo K Myint Journal: J Am Heart Assoc Date: 2021-03-08 Impact factor: 5.501
Authors: Muhammad Afzaal; Farhan Saeed; Yasir Abbas Shah; Muzzamal Hussain; Roshina Rabail; Claudia Terezia Socol; Abdo Hassoun; Mirian Pateiro; José M Lorenzo; Alexandru Vasile Rusu; Rana Muhammad Aadil Journal: Front Microbiol Date: 2022-09-26 Impact factor: 6.064