title: Characteristics and early and long-term outcome in patients with acute ischemic stroke and low ejection fraction.
abstract: OBJECTIVE
  We assessed the clinical characteristics of patients with acute ischemic stroke (AIS) with left ventricular ejection fraction (EF) ≤ 35% and investigated the association of low EF with early and long-term outcome.
  
  
  METHODS
  A total of 2439 patients of the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) were selected. Demographics, risk factors, pre-stroke treatment, and clinical, radiological and metabolic variables in patients with and without low EF were compared. Functional independence (modified Rankin Score ≤ 2) and mortality were recorded 1 week up to 12 months from admission.
  
  
  RESULTS
  Low EF patients (n=119) were more commonly men, older, had higher rates of coronary artery disease and atrial fibrillation (AF), and more frequent pretreatment with anticoagulants, antiplatelets and antihypertensive agents. On admission, they presented with higher stroke severity and had lower values of systolic blood pressure, higher heart rate, and worse estimated glomerular filtration rate. Stroke-related disability and death rates were higher in low EF patients during follow-up (19.5% vs. 7.8% at 1 week, and 36.1% vs. 16.5% at 12 months). Increasing age, stroke severity, and AF were independent predictors of one-year mortality in these patients while prior use of statins had a favorable effect on early mortality.
  
  
  CONCLUSIONS
  AIS in patients with low EF is associated with older age, cardiac comorbidities, and more severe clinical presentation. Low EF can identify a subset of AIS patients at high risk of early and long-term functional disability and mortality.
authors.affiliation: Neurology Service, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
authors.forename: Haralampos
authors.initials: H
authors.lastname: Milionis
authors.forename: Mohamed
authors.initials: M
authors.lastname: Faouzi
authors.forename: Maria
authors.initials: M
authors.lastname: Cordier
authors.forename: Suzette
authors.initials: S
authors.lastname: D'Ambrogio-Remillard
authors.forename: Ashraf
authors.initials: A
authors.lastname: Eskandari
authors.forename: Patrik
authors.initials: P
authors.lastname: Michel
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D020521:Stroke / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D013318:Stroke Volume / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome