Clinical characteristics, precipitating factors, management and outcome of patients with prior stroke hospitalised with heart failure: an observational report from the Middle East

Abstract

ObjectivesThe 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).DesignRetrospective analysis of prospectively collected data.SettingData 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.ParticipantsA total of 5005 patients with HF.Outcome measuresIn-hospital and 1-year outcome.ResultsThe 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.ConclusionsThis 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.Trial registration numberNCT01467973.

Prognostic Impact of Diabetes on Long-term Survival Outcomes in Patients With Heart Failure: A Meta-analysis

“…The forest plot shown in Fig. 1 includes a total of 41 studies (12 RCTs [31,41,44,46,50,53,56,60,62,[65][66][67] and 29 observational registries [28,29,[32][33][34][35][36][37][38][39]42,43,45,48,49,51,52,54,55,[57][58][59]63,64,[68][69][70][71]73]) and provides the distribution of studies by estimate of the association between diabetes and the risk of all-cause death in 371,663 patients with HF (26.4% with diabetes), stratified by both HF subtype and study design.…”

Implications of a History of Syncope in Patients Hospitalized With Heart Failure

“…Data variables used in the study were defined based on the ESC guidelines 2008 and the American College of Cardiology clinical data standards 2005, [10][11][12] as shown in Table 1. Definition of syncope was described as previously given by the Task Force for the Diagnosis and Management of Syncope (2009).…”

Does Prior Stroke Predict Long-Term Recurrent Stroke After Percutaneous Coronary Intervention? Five-Year Results From a Large Cohort Study

“…Patients with cardiovascular diseases and prior stroke were more likely to have more atherosclerotic risk factors, such as higher age, diabetes mellitus, hypertension, hyperlipidemia, chronic kidney disease, and peripheral arterial disease ( 15 ). Similarly, CHD patients with prior stroke in our study had worse baseline characteristics, including higher age, female gender, and more CHD risk factors such as hypertension, diabetes, hyperlipidemia, smoking, and much complex coronary anatomy.…”