%0 Journal Article %A Tiberiu A Pana %A Adrian D Wood %A Jesus A Perdomo-Lampignano %A Somsak Tiamkao %A Allan B Clark %A Kannikar Kongbunkiat %A Joao H Bettencourt-Silva %A Kittisak Sawanyawisuth %A Narongrit Kasemsap %A Mamas A Mamas %A Phyo K Myint %T Impact of heart failure on stroke mortality and recurrence %D 2019 %R 10.1136/heartasia-2018-011139 %J Heart Asia %P e011139 %V 11 %N 1 %X Objective We aimed to examine the impact of heart failure (HF) on stroke mortality (in-hospital and postdischarge) and recurrence in a national stroke cohort from Thailand.Methods We used a large, insurance-based database including all stroke admissions in the public health sector in Thailand between 2004 and 2015. Logistic and Royston-Parmar regressions were used to quantify the effect of HF on in-hospital and long-term outcomes, respectively. All models were adjusted for age, sex and comorbidities and stratified by stroke type: acute ischaemic stroke (AIS) or intracerebral haemorrhage (ICH). Multistate models were constructed using flexible survival techniques to predict the impact of HF on the disease course of a patient with stroke (baseline-[recurrence]-death). Only first-ever cases of AIS or ICH were included in the multistate analysis.Results 608 890 patients (mean age 64.29±13.72 years, 55.07% men) were hospitalised (370 527 AIS, 173 236 ICH and 65 127 undetermined pathology). There were 398 663 patients with first-ever AIS and ICH. Patients were followed up for a median (95% CI) of 4.47 years (4.45 to 4.49). HF was associated with an increase in postdischarge mortality in AIS (HR [99% CI] 1.69 [1.64 to 1.74]) and ICH (2.59 [2.07 to 3.26]). HF was not associated with AIS recurrence, while ICH recurrence was only significantly increased within the first 3 years after discharge (1.79 [1.18 to 2.73]).Conclusions HF increases the risk of mortality in both AIS and ICH. We are the first to report on high-risk periods of stroke recurrence in patients with HF with ICH. Specific targeted risk reduction strategies may have significant clinical impact for mortality and recurrence in stroke. %U https://heartasia.bmj.com/content/heartasia/11/1/e011139.full.pdf