Abstract 9917: Stroke Survivors with Asthma Have Worse Cardiovascular Outcomes

Abstract

Introduction: Studies have shown that asthmatics have higher risk for cardiovascular (CV) disease and all-cause mortality than non-asthmatics. However, only a few studies have examined the role asthma has on CV outcomes of stroke survivors. Hypothesis: Stroke survivors with asthma have higher risk of CV outcomes (1- and 5-year all-cause mortality, 1- and 5-year admission for stroke recurrence, first occurrence of MI, or HF) than matched stroke survivors without asthma. Methods: A total of 271,260 patients, 18-years-old and older, with index stroke and without a history of HF, MI, or COPD from January 1, 1995 to December 31, 2015 were identified in the Myocardial Infarction Data Acquisition System, a database of all admissions to non-federal hospitals in New Jersey. A matched analysis was performed by separating the cohort into asthmatics (n=11,702) and non-asthmatics (n=34,950) and matched 1 asthmatic up to 3 non-asthmatics. Data was analyzed by matching patient and clinical characteristics. The association of asthma with each of the above outcomes was assessed using logistic regression, log-rank test, and Cox models. Results: There was no difference in 1-and 5-year all-cause mortality (p=0.102 and p=0.488, respectively). Patients with asthma were more likely to be readmitted for stroke within 1 year (hazard ratio (HR)= 1.08, 95% CI 1.00-1.16, p=0.041) and had first admission for HF at 1 year (HR 1.38, 95% CI 1.09-1.73, p=0.006) compared to matched controls. Also, they were more likely to be readmitted for stroke within 5 years (HR 1.08, 95% CI 1.02-1.15, p=0.007) and to be admitted for first HF within 5 years (HR 1.27, 95% CI 1.12-1.44, p<0.001) (Figure). There were no significant differences in 1-year and 5-year first MI admissions. Conclusion: Stroke survivors with asthma have higher risk for stroke readmission and first HF admission compared to matched controls. Randomized studies are needed to confirm these findings and stimulate focused efforts to mitigate this risk.