Heart disease contributes to high stroke mortality in Poland.
BACKGROUND
The case-fatality rate for ischemic stroke in Poland are 3 times higher than in the United States. The reason for this difference is uncertain.


OBJECTIVE
To explore whether cardiac comorbidity contributes to high case-fatality rates for ischemic stroke in Poland.


METHODS
Prospective collection of data on ischemic stroke by using a structured data collection instrument.


METHODS
A regional neurological hospital in Warsaw.


METHODS
Standard medical care was provided to all ischemic stroke patients.


METHODS
Survival at 30 days, stroke lesion size and location by computerized tomographic scan, stroke syndrome.


RESULTS
252 patients with ischemic stroke were registered. Overall 30-day case-fatality rate was significantly higher in the group of patients with atrial fibrillation (AF) (28.6% v 13.9%) and congestive heart failure (CHF) (29.1% v 12.7%) than in those without these comorbidities. In patients with either AF or CHF, ischemic lesions seen on computed tomography (CT) scans were more likely to be very large (occupying more than 1 lobe) and were more likely to involve both superficial and deep structures of the brain. Large hemispheric syndromes were more likely in patients with AF (38.5% v 18.5%) and CHF (33.8% v 18.9%) than in those without these comorbidities.


CONCLUSIONS
Strokes caused by CHF or AF tend to be larger and are more likely to lead to death. The high prevalence of cardiac disease may be one cause of high stroke mortality in Poland.
Czlonkowska
A
A
Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
Hier
D B
DB
Mendel
T
T
Ryglewicz
D
D