Heart failure, recurrent vascular events and death in patients with ischemic stroke-results of the MonDAFIS study
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Heart failure, recurrent vascular events and death in patients with ischemic stroke-results of the MonDAFIS study. / MonDAFIS Investigators.
In: INTERN EMERG MED, Vol. 19, No. 5, 08.2024, p. 1247-1254.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Heart failure, recurrent vascular events and death in patients with ischemic stroke-results of the MonDAFIS study
AU - Tütüncü, Serdar
AU - Olma, Manuel C
AU - Kunze, Claudia
AU - Dietzel, Joanna
AU - Schurig, Johannes
AU - Rosenkranz, Michael
AU - Stingele, Robert
AU - Maschke, Matthias
AU - Heuschmann, Peter U
AU - Kirchhof, Paulus
AU - Laufs, Ulrich
AU - Nabavi, Darius G
AU - Röther, Joachim
AU - Thomalla, Götz
AU - Veltkamp, Roland
AU - Endres, Matthias
AU - Haeusler, Karl Georg
AU - MonDAFIS Investigators
N1 - © 2024. The Author(s).
PY - 2024/8
Y1 - 2024/8
N2 - Heart failure (HF) is associated with poor outcome after stroke, but data from large prospective trials are sparse.We assessed the impact of HF on clinical endpoints in patients hospitalized with acute ischemic stroke or transient ischemic attack (TIA) enrolled in the prospective, multicenter Systematic Monitoring for Detection of Atrial Fibrillation in Patients with Acute Ischemic Stroke (MonDAFIS) trial. HF was defined as left ventricular ejection fraction (LVEF) < 55% or a history of HF on admission. The composite of recurrent stroke, major bleeding, myocardial infarction, and all-cause death, and its components during the subsequent 24 months were assessed. We used estimated hazard ratios in confounder-adjusted models. Overall, 410/2562 (16.0%) stroke patients fulfilled the HF criteria (i.e. 381 [14.9%] with LVEF < 55% and 29 [1.9%] based on medical history). Patients with HF had more often diabetes, coronary and peripheral arterial disease and presented with more severe strokes on admission. HF at baseline correlated with myocardial infarction (HR 2.21; 95% CI 1.02-4.79), and all-cause death (HR 1.67; 95% CI 1.12-2.50), but not with major bleed (HR 1.93; 95% CI 0.73-5.06) or recurrent stroke/TIA (HR 1.08; 95% CI 0.75-1.57). The data were adjusted for age, stroke severity, cardiovascular risk factors, and randomization. Patients with ischemic stroke or TIA and comorbid HF have a higher risk of myocardial infarction and death compared with non-HF patients whereas the risk of recurrent stroke or major hemorrhage was similar. Trial registration number Clinicaltrials.gov NCT02204267.
AB - Heart failure (HF) is associated with poor outcome after stroke, but data from large prospective trials are sparse.We assessed the impact of HF on clinical endpoints in patients hospitalized with acute ischemic stroke or transient ischemic attack (TIA) enrolled in the prospective, multicenter Systematic Monitoring for Detection of Atrial Fibrillation in Patients with Acute Ischemic Stroke (MonDAFIS) trial. HF was defined as left ventricular ejection fraction (LVEF) < 55% or a history of HF on admission. The composite of recurrent stroke, major bleeding, myocardial infarction, and all-cause death, and its components during the subsequent 24 months were assessed. We used estimated hazard ratios in confounder-adjusted models. Overall, 410/2562 (16.0%) stroke patients fulfilled the HF criteria (i.e. 381 [14.9%] with LVEF < 55% and 29 [1.9%] based on medical history). Patients with HF had more often diabetes, coronary and peripheral arterial disease and presented with more severe strokes on admission. HF at baseline correlated with myocardial infarction (HR 2.21; 95% CI 1.02-4.79), and all-cause death (HR 1.67; 95% CI 1.12-2.50), but not with major bleed (HR 1.93; 95% CI 0.73-5.06) or recurrent stroke/TIA (HR 1.08; 95% CI 0.75-1.57). The data were adjusted for age, stroke severity, cardiovascular risk factors, and randomization. Patients with ischemic stroke or TIA and comorbid HF have a higher risk of myocardial infarction and death compared with non-HF patients whereas the risk of recurrent stroke or major hemorrhage was similar. Trial registration number Clinicaltrials.gov NCT02204267.
U2 - 10.1007/s11739-024-03594-8
DO - 10.1007/s11739-024-03594-8
M3 - SCORING: Journal article
C2 - 38619714
VL - 19
SP - 1247
EP - 1254
JO - INTERN EMERG MED
JF - INTERN EMERG MED
SN - 1828-0447
IS - 5
ER -