title: Clinical characteristics, precipitating factors, management and outcome of patients with prior stroke hospitalised with heart failure: an observational report from the Middle East.
abstract: OBJECTIVE
  The purpose of this study is to report the prevalence, clinical characteristics, precipitating factors, management and outcome of patients with prior stroke hospitalised with acute heart failure (HF).
  
  
  METHODS
  Retrospective analysis of prospectively collected data.
  
  
  METHODS
  Data were derived from Gulf CARE (Gulf aCute heArt failuRe rEgistry), a prospective multicentre study of consecutive patients hospitalised with acute HF in 2012 in seven Middle Eastern countries and analysed according to the presence or absence of prior stroke; demographics, management and outcomes were compared.
  
  
  METHODS
  A total of 5005 patients with HF.
  
  
  METHODS
  In-hospital and 1-year outcome.
  
  
  RESULTS
  The prevalence of prior stroke in patients with HF was 8.1%. Patients with stroke with HF were more likely to be admitted under the care of internists rather than cardiologists. When compared with patients without stroke, patients with stroke were more likely to be older and to have diabetes mellitus, hypertension, atrial fibrillation, hyperlipidaemia, chronic kidney disease, ischaemic heart disease, peripheral arterial disease and left ventricular dysfunction (p=0.001 for all). Patients with stroke were less likely to be smokers (0.003). There were no significant differences in terms of precipitating risk factors for HF hospitalisation between the two groups. Patients with stroke with HF had a longer hospital stay (mean±SD days; 11±14 vs 9±13, p=0.03), higher risk of recurrent strokes and 1-year mortality rates (32.7% vs 23.2%, p=0.001). Multivariate logistic regression analysis showed that stroke is an independent predictor of in-hospital and 1-year mortality.
  
  
  CONCLUSIONS
  This observational study reports high prevalence of prior stroke in patients hospitalised with HF. Internists rather than cardiologists were the predominant caregivers in this high-risk group. Patients with stroke had higher risk of in-hospital recurrent strokes and long-term mortality rates.
  
  
  BACKGROUND
  NCT01467973.
authors.affiliation: Department of Cardiology, Saint Michael's Hospital, Toronto University, Canada.
authors.forename: Hadi A R
authors.initials: HA
authors.lastname: Khafaji
authors.affiliation: Department of Cardiology, Royal Hospital, Muscat, Oman.
authors.forename: Kadhim
authors.initials: K
authors.lastname: Sulaiman
authors.affiliation: Biostatistics Section, Cardiovascular Research, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Rajvir
authors.initials: R
authors.lastname: Singh
authors.affiliation: Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Khalid F
authors.initials: KF
authors.lastname: AlHabib
authors.affiliation: Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Nidal
authors.initials: N
authors.lastname: Asaad
authors.affiliation: Department of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, UAE.
authors.forename: Alawi
authors.initials: A
authors.lastname: Alsheikh-Ali
authors.affiliation: Department of Cardiology, Sabah Al-Ahmed Cardiac Center, Kuwait.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Jarallah
authors.affiliation: Department of Cardiology, Sabah Al-Ahmed Cardiac Center, Kuwait.
authors.forename: Bassam
authors.initials: B
authors.lastname: Bulbanat
authors.affiliation: Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Wael
authors.initials: W
authors.lastname: AlMahmeed
authors.affiliation: Department of Cardiology, Adan Hospital, Kuwait, Kuwait.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ridha
authors.affiliation: Department of Cardiology, Dubai hospital, Dubai, UAE.
authors.forename: Nooshin
authors.initials: N
authors.lastname: Bazargani
authors.affiliation: Department of Cardiology, Mohammed Bin Khalifa Cardiac Center, Manamah, Bahrain.
authors.forename: Haitham
authors.initials: H
authors.lastname: Amin
authors.affiliation: Department of Cardiology, Faculty of Medicine, Sana'a University, Sana'a, Yemen.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Motarreb
authors.affiliation: Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Hussam
authors.initials: H
authors.lastname: AlFaleh
authors.affiliation: Department of Cardiology, Prince Salman Heart Center, King Fahad Medical City, Saudi Arabia Department or Cardiology, Tanta University, Tanta, Egypt.
authors.forename: Abdelfatah
authors.initials: A
authors.lastname: Elasfar
authors.affiliation: Department of Cardiology, Royal Hospital, Muscat, Oman.
authors.forename: Prashanth
authors.initials: P
authors.lastname: Panduranga
authors.affiliation: Biostatistics Section, Cardiovascular Research, Heart Hospital, Hamad Medical Corporation, Doha, Qatar Qatar Cardiovascular Research Center and Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Jassim
authors.initials: J
authors.lastname: Al Suwaidi
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology; D002309:Cardiology; D015331:Cohort Studies; D015897:Comorbidity; D019468:Disease Management; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology; D007388:Internal Medicine; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000453:epidemiology; D058729:Peripheral Arterial Disease / Q000453:epidemiology; D015985:Precipitating Factors; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology*; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology
keywords: STROKE MEDICINE