title: The coexistence of heart failure predicts short term mortality, but not disability, in patients with acute ischemic stroke treated with thrombolysis: the Florence area Registry.
abstract: BACKGROUND
  Thrombolysis in ischemic stroke reduces disability but not mortality. Our aim was to evaluate the predictivity of heart failure (HF) diagnosis on 90-day mortality and disability in stroke patients undergoing thrombolysis.
  
  
  METHODS
  Hospital records of all consecutive stroke patients treated with thrombolysis at our University Hospital were reviewed. Clinical assessment for HF and echocardiogram were available for all patients according to the thrombolysis institutional protocol. History of HF, LVEF <40%, or BOSTON score ≥ 5 were tested as predictors.
  
  
  RESULTS
  Of 130 patients (age 66 ± 14 years, 64.6% males, baseline NIHSS 15.6 ± 8.8), 17 (13.1%) had a history of HF, 16 (12.7%) a BOSTON score ≥ 5, 13 (10.9%) a LVEF <40% and 24 (19.0%) met clinical criteria for HF diagnosis. Ninety-day mortality and incidence of disability were 16.1% and 36.1%, respectively. After adjustment for age, sex, baseline stroke severity and pre-stroke disability, LVEF <40% and clinical diagnosis of HF were predictors of 90-day mortality, (p=0.007 and p=0.037, respectively).
  
  
  CONCLUSIONS
  Clinical diagnosis of HF predicts mortality, but not disability, in acute stroke patients undergoing thrombolysis. Unlike anamnestic record of HF, clinical evaluation of cardiac function, with estimation of LVEF, predicts mortality.
authors.affiliation: Stroke Unit, Department of Neurological and Psychiatric Sciences, Careggi University Hospital, Florence, Italy.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Palumbo
authors.forename: Samuele
authors.initials: S
authors.lastname: Baldasseroni
authors.forename: Patrizia
authors.initials: P
authors.lastname: Nencini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pracucci
authors.forename: Francesco
authors.initials: F
authors.lastname: Arba
authors.forename: Benedetta
authors.initials: B
authors.lastname: Piccardi
authors.forename: Giosafat Andrea
authors.initials: GA
authors.lastname: Marella
authors.forename: Mauro
authors.initials: M
authors.lastname: Di Bari
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.forename: Niccolò
authors.initials: N
authors.lastname: Marchionni
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator