Heart failure in acute ischemic stroke.
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.


CONCLUSIONS
Both forms of HF (with or without decreased systolic function) are associated with poor outcome in AIS.
Ois
Angel
A
Unit of Neurovascular Research, Neurology Department, Institut Municipal d'Investigació Mèdica - Hospital del Mar, Departament de Medicina, Universitat Autònoma de Barcelona, Spain. 94545@imas.imim.es
Gomis
Meritxell
M
Cuadrado-Godia
Elisa
E
Jiménez-Conde
Jordi
J
Rodríguez-Campello
Ana
A
Bruguera
Jordi
J
Molina
Lluis
L
Comin
Josep
J
Roquer
Jaume
J
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications*; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000209:etiology; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D016277:Ventricular Function, Left