title: Stroke and Heart Failure: Clinical Features, Access to Care, and Outcomes.
abstract: OBJECTIVE
  Limited information is known regarding acute ischemic stroke (AIS) and heart failure (HF). The aim of the study was to evaluate clinical characteristics, predisposing factors, and outcomes in AIS with HF.
  
  
  METHODS
  We included AIS patients admitted to the institutions participating in the Registry of the Canadian Stroke Network. HF was defined as history of pre-existing HF or pulmonary edema present at the time of arrival. The primary outcome was death or disability at discharge (modified Rankin Scale score >3). Secondary outcomes included disposition, death at 3 months and at 1 year, and 30-day hospital readmissions.
  
  
  RESULTS
  Among 12,396 patients, HF was found in 1124 (9.1%) patients. HF was associated with higher risk of death at 30 days (24.5% versus 11.2%, P < .0001), at 1 year (44.3% versus 20.6, P < .0001), and disability at discharge (70.4% versus 56%, P < .0001). In the multivariable analysis, HF was an independent predictor of death and disability (odds ratio 1.18, 95% confidence interval [CI] 1.01-1.37), death at 30 days (hazard ratio [HR] 1.22, 95% CI 1.05-1.41), and hospital readmissions (HR 1.32, 95% CI 1.05-1.65) at 30 days. The results were unaltered when adjusting for pneumonia with the exception of death or disability at discharge.
  
  
  CONCLUSIONS
  In this large cohort study, HF was observed in 9.1% of AIS patients. HF is an independent predictor of death and disability and hospital readmissions after stroke at 30 days.
authors: Stroke Outcomes Research Center, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors: Jitphapa
authors: J
authors: Pongmoragot
authors: Peter Munk Cardiac Centre, Joint Department of Medical Imaging, Institute for Clinical Evaluative Science, IHPME, University Health Network, Toronto, Ontario, Canada.
authors: Douglas S
authors: DS
authors: Lee
authors: Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea.
authors: Tai Hwan
authors: TH
authors: Park
authors: Department of Statistics, Institute of Clinical Evaluative Sciences (ICES), Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada.
authors: Jiming
authors: J
authors: Fang
authors: Department of Statistics, Institute of Clinical Evaluative Sciences (ICES), Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada.
authors: Peter C
authors: PC
authors: Austin
authors: Stroke Outcomes Research Center, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. Electronic address: saposnikg@smh.ca.
authors: Gustavo
authors: G
authors: Saposnik
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D016009:Chi-Square Distribution; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D006297:Health Services Accessibility; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D010351:Patient Discharge; D010359:Patient Readmission; D015995:Prevalence; D017064:Process Assessment, Health Care; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Stroke; heart failure; outcomes; quality of care