Ischaemic stroke in women and men – in-hospital prognosis

Tracz, Justyna; Gorczyca, Iwona; Wełnicki, Marcin; Rosołowska, Anita; Mamcarz, Artur; Wożakowska−Kapłon, Beata

doi:10.5114/ms.2022.115144

Cited by 2 publications

(4 citation statements)

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“…Conversely, in the PINNACLE Registry [28], in a group of American patients with AF and recommended OACs, female sex was connected with significantly lower OAC use compared to male sex in the whole spectrum of thromboembolic risk. There are factors that worsen stroke prognosis according to gender [29]. Women may be more prone to refuse OAC treatment, especially warfarin, due to the fear of bleeding.…”

Section: Discussionmentioning

confidence: 99%

Secondary prevention of thromboembolic complications in patients with nonvalvular atrial fibrillation – clinical practice in relation to guidelines

Bielecka¹,

Gorczyca²,

Ciba-Stemplewska³

et al. 2023

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Introduction: Atrial fibrillation (AF) patients after past thromboembolic complications are at high risk of such subsequent complications and should undergo anticoagulant therapy. Aim of the research: To assess recommended anticoagulant prophylaxis in AF patients after past thromboembolic complications, and an attempt to identify predictors of oral anticoagulant (OAC) use and non-use among these patients. Material and methods: The presented research is a retrospective, unicentric study comprising 1266 AF patients with thromboembolic complications and CHA 2 DS 2 -VASc score ≥ 2, subsequently hospitalized from January 2004 to December 2019 in the referential cardiology centre. Results: In the group of 1266 patients, 1072 of them (84.7%) received OACs, 134 (10.6%) antiplatelet drugs, 36 (2.8%) low molecular weight heparin, and 24 (1.9%) remained without anticoagulant prophylaxis. Between 2004 and 2019 OAC application increased from 70.5% to 95.3% and antiplatelet pharmaceutical use decreased from 23.7% to 1.9%. Independent predictors of OAC use were female sex (OR = 1.57; 95% CI: 1.14-2.17; p = 0.006) and peripheral artery disease (PAD) (OR = 2.59; 95% Cl: 1.48-4.51; p = 0.001). Factors determining no OAC use were age > 74 years (OR = 0.64; 95% CI: 0.46-0.89; p = 0.007) and acute coronary syndrome (ACS) hospitalization or planned coronarography or percutaneous coronary intervention (PCI) (OR = 0.41; 95% CI: 0.28-0.61; p < 0.001). Between 2004 and 2019 an increase in the number of high-risk thromboembolic patients treated with OACs was observed. Conclusions: Independent predictors of OAC use were sex and PAD. The factors that reduced the chance of OAC use were age > 74 years, ACS hospitalization, or planned coronarography or PCI. StreszczenieWprowadzenie: Pacjenci z migotaniem przedsionków (AF) po przebytym powikłaniu zakrzepowo-zatorowym są chorymi wysokiego ryzyka kolejnych takich powikłań i powinni otrzymywać leczenie przeciwkrzepliwe. Cel pracy: Ocena zalecanej profilaktyki przeciwkrzepliwej u chorych z AF po przebytym powikłaniu zakrzepowo-zatorowym oraz próba identyfikacji predyktorów stosowania oraz niestosowania doustnych leków przeciwkrzepliwych (OAC) wśród tych chorych. Materiał i metody: Prezentowane badanie jest retrospektywnym, jednoośrodkowym badaniem obejmującym kolejno 1266 hospitalizowanych pacjentów z AF oraz powikłaniami zakrzepowo-zatorowymi oraz wynikiem w skali CHA 2 DS 2 -VASc ≥ 2 pkt, w referencyjnym ośrodku kardiologicznym od stycznia 2004 do grudnia 2019 roku.

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Section: Discussionmentioning

confidence: 99%

Secondary prevention of thromboembolic complications in patients with nonvalvular atrial fibrillation – clinical practice in relation to guidelines

Bielecka¹,

Gorczyca²,

Ciba-Stemplewska³

et al. 2023

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“…[19,[26][27][28][29][30] The risk of death after stroke was reported in 12 articles. [8][9][10]16,26,[31][32][33][34][35][36][37] Most studies of stroke risk in COPD adjusted for risk factors such as age, sex, and comorbidities, and only 2 studies had single-factor regression analysis data. [17,38] Four studies provided separate data on the risk of ischemic stroke, [17][18][19][20] and 4 studies provided separate risk data for hemorrhagic stroke.…”

Section: Basic Characteristics Of Included Studiesmentioning

confidence: 99%

“…Of the stroke prognosis studies, a total of 8 cohorts in 6 publications reported short-term patient prognosis outcomes. [9,10,16,33,36,37] A total of 10 cohorts in 8 publications provided data on the risk of death at more than 1 year of follow-up after stroke. [8,9,26,[31][32][33][34][35] Among the prognostic studies, 1 study provided data on the risk of stroke prognosis for COPD with different diagnostic modalities.…”

Section: Basic Characteristics Of Included Studiesmentioning

confidence: 99%

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Stroke risk of COPD patients and death risk of COPD patients following a stroke: A systematic review and meta-analysis

Ding,

Wang,

Gong

et al. 2023

Medicine

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Objective: Chronic obstructive pulmonary disease (COPD) is closely related to the development and progression of cardiovascular disease. The purpose of this study is to clarify the answers to the following questions through systematic evaluation: the risk of stroke in COPD patients; the risk of stroke in acute exacerbations of COPD (AECOPD) patients; and the risk of death after stroke in COPD patients. Methods: Two reviewers independently searched EMbase, PubMed, and the Cochrane Library for relevant literature from the date of creation to February 17, 2023, for studies relating COPD to stroke patients. Of the 8039 publications retrieved, we identified 27 articles that met our selection criteria. Fixed-effects or random-effects models were used to calculate ORs and 95% confidence intervals for the combined risk. Results: combining studies on stroke risk in COPD patients by random-effects model suggested that COPD was an independent risk factor for stroke-associated pneumonia (OR 1.40, 95% CI: 1.24–1.59, I 2 = 98.4%, P = .000), with significant heterogeneity in the results, and subgroup analysis did not find a source of heterogeneity. In the combined 7 AECOPD studies, a significantly higher risk of stroke was found (OR 1.53, 95% CI: 1.44–1.63, I 2 = 49.2%, P = .066). In the combined 6 short- term prognostic studies, the relationship between COPD and risk of death was not highly significant (OR 1.12, 95% CI: 1.08–1.16, I 2 = 37.4%, P = .131). In 10 long-term observational prognosis studies, COPD was suggested to be associated with death after stroke by combining data using a random-effects model (OR 1.20, 95% CI: 1.13–1.27, I 2 = 56.8%, P = .014), and there was moderate heterogeneity in the combination, with subgroup analysis showing that stroke type may be a source of heterogeneity and the risk of death from ischemic stroke: OR 1.23, 95% CI: 1.17–1.29, I 2 = 45.0%, P = .191 and the risk of death from both types of stroke: OR 1.12, 95% CI: 1.07–1.18, I 2 =18.9%, P = .291. Conclusion: COPD is an independent risk factor for stroke. The risk of stroke is significantly increased, especially during AECOPD. In addition, the association between COPD and short-term death in stroke patients is insignificant, while it is more associated with fatal events in the long-term prognosis.

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Ischaemic stroke in women and men – in-hospital prognosis

Cited by 2 publications

References 0 publications

Secondary prevention of thromboembolic complications in patients with nonvalvular atrial fibrillation – clinical practice in relation to guidelines

Secondary prevention of thromboembolic complications in patients with nonvalvular atrial fibrillation – clinical practice in relation to guidelines

Stroke risk of COPD patients and death risk of COPD patients following a stroke: A systematic review and meta-analysis

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