The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction.
Details
State: Public
Version: Final published version
License: Not specified
Serval ID
serval:BIB_2EE0491CC900
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction.
Journal
European stroke journal
Working group(s)
RAF and RENO-EXTEND Investigators
Contributor(s)
Agnelli G., Caso V., Becattini C., Mosconi M.G., Giustozzi M., Tsivgoulis G., Seiffge D.J., Engelter S.T., Lyrer P., Polymeris A.A., Dittrich T., Zietz A., Putaala J., Strbian D., Tomppo L., Michel P., Strambo D., Salerno A., Remillard S., Buehrer M., Bavaud O., Vanacker P., Zuurbier S.M., Yperzeele L., Loos C.M., Cappellari M., Emiliani A., Zedde M., Abdul-Rahim A.H., Dawson J., Cronshaw R., Schirinzi E., Del Sette M., Stretz C., Kala N., Reznik M., Schomer A., Mac Grory B., Jayaraman M., Yaghi S., Furie K.L., Masotti L., Grifoni E., Toni D., Risitano A., Falcou A., Petraglia L., Lotti E.M., Padroni M., Pavolucci L., Lochner P., Silvestrelli G., Ciccone A., Alberti A., Venti M., De Magistris I.L., Cancelloni V., Kargiotis O., Rocco A., Diomedi M., Marcheselli S., Caliandro P., Zauli A., Reale G., Moci M., Antonenko K., Rota E., Tassinari T., Saia V., Palmerini F., Aridon P., Arnao V., Monaco S., Cottone S., Baldi A., Amore C. d', Ageno W., Pegoraro S., Ntaios G., Sagris D., Giannopoulos S., Kosmidou M., Ntais E., Romoli M., Pantoni L., Rosa S., Bertora P., Chiti A., Canavero I., Saggese C.E., Plocco M., Giorli E., Palaiodimou L., Bakola E., Bandini F., Gasparro A., Terruso V., Mannino M., Pezzini A., Morotti A., Magoni M., Ornello R., Sacco S., Popovic N., Scoditti U., Genovese A., Denti L., Flomin Y., Mancuso M., Ferrari E., Caselli M.C., Ulivi L., Giannini N., Vadikolias K., Liantinioti C., Chondrogianni M., Carletti M., Karagkiozi E., Athanasakis G., Makaritsis K., Lanari A., Tatlisumak T., Acciarresi M., Vannucchi V., Lorenzini G., Tassi R., Guideri F., Acampa M., Martini G., Sohn S.I., Mumoli N., Tadi P., Letteri F., Maccarrone M., Galati F., Tiseo C., Gourbali V., Halvatsiotis P., Orlandi G., Giuntini M., Corea F., Bellesini M., Baronello M.M., Karapanayiotides T., Rueckert C., Csiba L., Szabó L., Rigatelli A., Imberti D., Zabzuni D., Pieroni A., Barlinn K., Pallesen L.P., Barlinn J., Doronin B., Volodina V., Deleu D., Bonetti B., Porta C., Gentile L., Eskandari A., De Marchis G.M.
ISSN
2396-9881 (Electronic)
ISSN-L
2396-9873
Publication state
Published
Issued date
09/2023
Peer-reviewed
Oui
Volume
8
Number
3
Pages
731-737
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Atrial fibrillation (AF) and congestive heart failure often coexist due to their shared risk factors leading to potential worse outcome, particularly cerebrovascular events. The aims of this study were to calculate the rates of ischemic and severe bleeding events in ischemic stroke patients having both AF and reduced ejection fraction (rEF) (⩽40%), compared to ischemic stroke patients with AF but without rEF.
We performed a retrospective analysis that drew data from prospective studies. The primary outcome was the composite of either ischemic (stroke or systemic embolism), or hemorrhagic events (symptomatic intracranial bleeding and severe extracranial bleeding).
The cohort for this analysis comprised 3477 patients with ischemic stroke and AF, of which, 643 (18.3%) had also rEF. After a mean follow-up of 7.5 ± 9.1 months, 375 (10.8%) patients had 382 recorded outcome events, for an annual rate of 18.0%. While the number of primary outcome events in patients with rEF was 86 (13.4%), compared to 289 (10.2%) for the patients without rEF; on multivariable analysis rEF was not associated with the primary outcome (OR 1.25; 95% CI 0.84-1.88). At the end of follow-up, 321 (49.9%) patients with rEF were deceased or disabled (mRS ⩾3), compared with 1145 (40.4%) of those without rEF; on multivariable analysis, rEF was correlated with mortality or disability (OR 1.35; 95% CI 1.03-1.77).
In patients with ischemic stroke and AF, the presence of rEF was not associated with the composite outcome of ischemic or hemorrhagic events over short-term follow-up but was associated with increased mortality or disability.
We performed a retrospective analysis that drew data from prospective studies. The primary outcome was the composite of either ischemic (stroke or systemic embolism), or hemorrhagic events (symptomatic intracranial bleeding and severe extracranial bleeding).
The cohort for this analysis comprised 3477 patients with ischemic stroke and AF, of which, 643 (18.3%) had also rEF. After a mean follow-up of 7.5 ± 9.1 months, 375 (10.8%) patients had 382 recorded outcome events, for an annual rate of 18.0%. While the number of primary outcome events in patients with rEF was 86 (13.4%), compared to 289 (10.2%) for the patients without rEF; on multivariable analysis rEF was not associated with the primary outcome (OR 1.25; 95% CI 0.84-1.88). At the end of follow-up, 321 (49.9%) patients with rEF were deceased or disabled (mRS ⩾3), compared with 1145 (40.4%) of those without rEF; on multivariable analysis, rEF was correlated with mortality or disability (OR 1.35; 95% CI 1.03-1.77).
In patients with ischemic stroke and AF, the presence of rEF was not associated with the composite outcome of ischemic or hemorrhagic events over short-term follow-up but was associated with increased mortality or disability.
Keywords
Humans, Atrial Fibrillation/complications, Prospective Studies, Retrospective Studies, Stroke Volume, Anticoagulants/adverse effects, Stroke/epidemiology, Hemorrhage/chemically induced, Ischemic Stroke/chemically induced, Acute stroke, atrial fibrillation, congestive heart failure
Pubmed
Web of science
Open Access
Yes
Create date
05/06/2023 8:46
Last modification date
28/09/2023 6:09
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