Importance of cardiovascular risk profile for in-hospital mortality due to cerebral infarction.
OBJECTIVE
To investigate cardiovascular risk profiles and their prognostic implications in patients with different subtypes of cerebral infarction.


METHODS
The study involved the retrospective analysis of data from a hospital stroke registry on 2704 consecutive CI patients who were admitted between 1986 and 2004. Of the 2704 strokes recorded, 770 were classified as thrombotic, 763 as cardioembolic, 733 as lacunar, 324 as undetermined and 114 as atypical. Multivariate analysis was used to compare cardiovascular risk profiles in each subtype and their influence on inhospital mortality.


RESULTS
Arterial hypertension (AH) was present in 55.5%, atrial fibrillation (AF) in 29.8%, and diabetes mellitus in 23.4%. The in-hospital mortality rate was 12.9%, and in-hospital mortality was independently associated with AF (odds ratio [OR]=2.33; 95% confidence interval [CI], 1.84-2.96), and heart failure (HF) (OR=1.96; 95% CI, 1.33-2.89). In patients with thrombotic stroke, the cardiovascular risk factors associated with in-hospital mortality were HF (OR=2.87; 95% CI, 1.45-5.71), AF (OR=1.80; 95% CI, 1.09-2.96) and age (OR=1.06; 95% CI, 1.04-1.08). In patients with cardioembolic stroke, they were peripheral vascular disease (OR=2.18; 95% CI, 1.17-4.05), previous cerebral infarction (OR=1.75; 95% CI, 1.16-2.63), HF (OR=1.71; 95% CI, 1.01-2.90), and age (OR=1.06; 95% CI, 1.04-1.08). In those with undetermined stroke, they were AH (OR=3.68; 95% CI, 1.78-7.62) and age (OR=1.05; 95% CI, 1.01-1.09).


CONCLUSIONS
Each cerebral infarction etiologic subtype was associated with its own cardiovascular risk profile. Consequently, the cardiovascular risk factors associated with mortality were also different for each ischemic stroke subtype.
Arboix
Adrià
A
Unidad de Enfermedades Vasculares Cerebrales, Servicio de Neurología, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Barcelona, Spain. aarboix@hscor.com
García-Eroles
Lluís
L
Comes
Emili
E
Oliveres
Montserrat
M
Targa
Cecília
C
Balcells
Miquel
M
Pujadas
Ramon
R
Massons
Joan
J
D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology; D002544:Cerebral Infarction / Q000209:etiology* / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors