Heart dysfunction in patients with acute ischemic stroke or TIA does not predict all-cause mortality at long-term follow-up.
BACKGROUND
Despite heart failure being a substantial risk factor for stroke, few studies have evaluated the predictive value of heart dysfunction for all-cause mortality in patients with acute ischemic stroke, in particular in the elderly. The aim of this study was to investigate whether impaired heart function in elderly patients can predict all-cause mortality after acute ischemic stroke or transient ischemic attack (TIA).


METHODS
A prospective long-term follow-up analysis was performed on a hospital cohort consisting of n = 132 patients with mean age 73 ± 9 years, presenting with acute ischemic stroke or transient ischemic attack, without atrial fibrillation. All patients were examined by echocardiography during the hospital stay. Data about all-cause mortality were collected at the end of the follow-up period. The mean follow-up period was 56 ± 22 months.


RESULTS
In this cohort, 58% of patients with acute ischemic stroke or TIA had heart dysfunction. Survival analysis showed that heart dysfunction did not predict all-cause mortality in this cohort. Furthermore, in multivariate regression analysis age (HR 5.401, Cl 1.97-14.78, p < 0.01), smoking (HR 3.181, Cl 1.36-7.47, p < 0.01), myocardial infarction (HR 2.826, Cl 1.17-6.83, p < 0.05) were independent predictors of all-cause mortality.


CONCLUSIONS
In this population with acute ischemic stroke or TIA and without non-valvular atrial fibrillation, impaired heart function does not seem to be a significant predictor of all-cause mortality at long-term follow-up.
Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. bjorn.andersson@vgregion.se.
Alexandra
A
Holmström
Michael L X
ML
Fu
Clara
C
Hjalmarsson
Lena
L
Bokemark
Björn
B
Andersson
D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000378:metabolism; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006331:Heart Diseases / Q000150:complications* / Q000453:epidemiology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D015996:Survival Rate; D020107:Troponin T / Q000378:metabolism
D006454:Hemoglobins; D020107:Troponin T; D002097:C-Reactive Protein; D002784:Cholesterol; D003404:Creatinine