Heart failure in acute ischemic stroke

J Neurol. 2008 Mar;255(3):385-9. doi: 10.1007/s00415-008-0677-1. Epub 2008 Mar 19.

Abstract

Background: To determine the impact of heart failure (HF), with preserved or decreased left ventricular function (LVF), on outcome in patients with acute ischemic stroke (AIS).

Methods: We studied 503 unselected ischemic stroke patients. Poor outcome was defined as moderate-severe disability or death at 90 days. We analyzed the association between poor outcome and HF with preserved LVF or decreased LVF (systolic HF: ejection fraction lower than 50%). We tested this association adjusted by possible confounders in a logistic regression model.

Results: 89 patients (17.7 %) had HF; 49 patients (9.7%) with systolic HF, and 40 (8%) patients with HF and preserved LVF. HF with preserved LVF patients were older [79.4 (7.9) vs. 74.3 (10.4), p = 0.013],more likely to be women [p < 0.001,OR = 8.61, 95% CI (3.3-22.6)], and with lower current smoking habits [p = 0.018, OR = 8.77 (1.1-72.6)] than patients with systolic HF. 151 patients (30 %) had poor outcome. We found an independent association with initial stroke severity, systolic HF (adjusted OR = 3.01), HF with preserved LVF (adjusted OR = 2.52), thrombolytic treatment, statin pre-treatment (as protectors) and poor outcome.

Conclusion: Both forms of HF (with or without decreased systolic function) are associated with poor outcome in AIS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Ischemia / complications*
  • Electrocardiography
  • Female
  • Heart Failure / etiology*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Risk Factors
  • Stroke / complications*
  • Stroke / etiology
  • Thrombolytic Therapy
  • Treatment Outcome
  • Ventricular Function, Left