Abstract
BackgroundDespite heart failure being a substantial risk factor for stroke, few studies have evaluated the predictive value of heart dysfunction for all-cause mortality in patients with acute ischemic stroke, in particular in the elderly. The aim of this study was to investigate whether impaired heart function in elderly patients can predict all-cause mortality after acute ischemic stroke or transient ischemic attack (TIA).MethodsA prospective long-term follow-up analysis was performed on a hospital cohort consisting of n = 132 patients with mean age 73 ± 9 years, presenting with acute ischemic stroke or transient ischemic attack, without atrial fibrillation. All patients were examined by echocardiography during the hospital stay. Data about all-cause mortality were collected at the end of the follow-up period. The mean follow-up period was 56 ± 22 months.ResultsIn this cohort, 58% of patients with acute ischemic stroke or TIA had heart dysfunction. Survival analysis showed that heart dysfunction did not predict all-cause mortality in this cohort. Furthermore, in multivariate regression analysis age (HR 5.401, Cl 1.97-14.78, p < 0.01), smoking (HR 3.181, Cl 1.36-7.47, p < 0.01), myocardial infarction (HR 2.826, Cl 1.17-6.83, p < 0.05) were independent predictors of all-cause mortality.ConclusionIn this population with acute ischemic stroke or TIA and without non-valvular atrial fibrillation, impaired heart function does not seem to be a significant predictor of all-cause mortality at long-term follow-up.
Highlights
Despite heart failure being a substantial risk factor for stroke, few studies have evaluated the predictive value of heart dysfunction for all-cause mortality in patients with acute ischemic stroke, in particular in the elderly
In a study of 1247 patients diagnosed with heart failure, Alberts et al found that the risk of ischemic stroke was strongly increased shortly after the diagnosis and returned to normal within 6 months [3]
Patient characteristics at baseline Totally, n = 932 patients with acute ischemic stroke or transient ischemic attack (TIA) were admitted to the stroke unit
Summary
Despite heart failure being a substantial risk factor for stroke, few studies have evaluated the predictive value of heart dysfunction for all-cause mortality in patients with acute ischemic stroke, in particular in the elderly. Heart failure was associated with poor prognosis and dependency in ischemic stroke patients [12,13,14,15]. It is currently discussed whether there is an independent association between low left ventricular ejection fraction (LVEF) and mortality in patients with ischemic stroke. Such an association between LVEF and mortality has been reported in some studies but not in all [13,16]
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