Abstract
Background and purpuse: Prognosis of cardioembolic stroke is poor In comparison with non-cardiogenic cerebral infarction. Impact of heart disease for non-cardiogenic cerebral infarction is not well known. We investigated the effects of heart disease for the prognosis of acute non-cardiogenic cerebral infarction. Methods: We retrospectively examined medical records of patients with acute ischemic stroke until April 2009 from March 2013, who was admitted in stroke care unit of our hospital. Stroke subtype were divided using the TOAST classification, cardioembolic stroke were excluded. Patients suffering from heart disease, such as ischemic heart disease, valvular disease, and congestive heart failure were classified in heart disease group. Other patients were in non-heart disease group. The two groups were compared in age, sex, clinical types of stroke based on TOAST, NIH stroke scale (NIHSS) at admission, modified Rankin scale (mRS) at discharge, risk factors for arteriosclerosis; hypertension, dyslipidemia, diabetes mellitus, smoking and obesity.Multivariate analysis for poor prognosis; mRS>5 at discharge, were underwent. Results: Of the 1106 acute ischemic stroke patients, 799 patients were non-cardiogenic stroke. Significant difference were showed between heart disease group (n=182) and non-heart disease group (n=617) in age (74.5 v.s. 68.7, p<0.0001), history of stroke (33.5% v.s. 24.2%, p=0.01), hypertension (87.9% v.s. 74.6%, p<0.0001), smoking (19.2% v.s. 31.3%, p=0.001), NIHSS at admission (6.4 v.s. 5.2, p=0.001), and mRS at discharge (2.5 v.s. 1.8, p<0.0001). Factors independently associated with poor outcome were NIHSS at admission (p<0.0001, 95% CI 1.03-1.10) and heart disease (p=0.04, 95% CI 1.01-2.07). Conclusions: Heart disease had a negative impact on prognosis of non-cardiogenic stroke. Further study is required strict control of heart disease may improve the prognosis.
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