Left ventricular hypertrophy assessed by electrocardiogram is associated with more severe stroke and with higher in-hospital mortality in patients with acute ischemic stroke

Τζιόμαλος, Κωνσταντίνος; Sofogianni, Areti; Angelopoulou, Stella-Maria; Kostaki, Stavroula; Papagianni, Marianthi; Satsoglou, Sarantis; Spanou, Marianna; Savopoulos, Christos; Hatzitolios, Apostolos

doi:10.1016/j.atherosclerosis.2018.05.030

Cited by 7 publications

(4 citation statements)

References 41 publications

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“…The National Institutes of Health Stroke Scale (NIHSS) score was assessed for all patients by qualified neurologists at admission to evaluate stroke severity ( 17 ). Based on a previous study, patients were divided into two groups: moderate to severe stroke (≥ 5 points) and mild stroke (< 5 points) ( 18 ). We evaluated the prognosis of clinical function by modified Rankin Scale (mRS) and Barthel index (BI) at 3 months after stroke onset.…”

Section: Methodsmentioning

confidence: 99%

Red cell distribution width is associated with stroke severity and unfavorable functional outcomes in ischemic stroke

Xue

Zhang²,

Zhang³

et al. 2022

Front. Neurol.

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BackgroundRed blood cell distribution width (RDW) is considered to be related to coronary heart disease and heart failure and all-cause mortality, but its relationship with acute ischemic stroke is still unclear. In this study, we aimed to explore the relationship between RDW and the stroke severity and functional outcomes of ischemic stroke.MethodsWe retrospectively reviewed patients with acute ischemic stroke between September 2016 and January 2020. Demographic, clinical, stroke complications, laboratory data, and treatment were collected for all patients. Stroke severity and functional outcomes were evaluated by NIHSS score, modified Rankin Scale (mRS), and Barthel Index (BI) at 3 months. Furthermore, multiple logistic regression analysis was used to assess the relationship between RDW and stroke severity and functional outcomes.ResultsA total of 629 patients with acute ischemic stroke were included and were categorized into four groups according to the quartiles of RDW (< 12.4, 12.4–12.9, 13.0–13.4, > 13.4). After multivariable analysis, higher RDW was directly associated with moderate to severe stroke (OR 2.21, 95% CI, 1.30–3.75, P = 0.003), mRS score of 3–6 at 3 months (OR 1.86, 95% CI, 1.02–3.41, P = 0.044), and BI score below 85 at 3 months (OR 2.27, 95% CI, 1.25–4.12, P = 0.007) in patients with ischemic stroke.ConclusionOur results demonstrate that RDW is associated with stroke severity and unfavorable functional outcomes at 3 months in patients with ischemic stroke.

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Section: Methodsmentioning

confidence: 99%

Red cell distribution width is associated with stroke severity and unfavorable functional outcomes in ischemic stroke

Xue

Zhang²,

Zhang³

et al. 2022

Front. Neurol.

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“…We prospectively studied all patients who were admitted to our department with acute IS between September 2010 and February 2018 ( n = 1107; 42.1% males, age 79.8 ± 7.2 years). Methods have been described previously [ 21 ]. Briefly, demographic data and the presence of cardiovascular risk factors or established cardiovascular disease (CVD) were recorded.…”

Section: Methodsmentioning

confidence: 99%

Hepatic Fibrosis Is a Risk Factor for Greater Severity and Worse Outcome of Acute Ischemic Stroke

Ztriva

Mentizis

Papadopoulos

et al. 2022

JCM

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Background: Nonalcoholic fatty liver disease, particularly in the presence of hepatic fibrosis, is associated with an increased risk of cardiovascular events, including ischemic stroke. However, it is unclear whether hepatic fibrosis is associated with the severity and outcome of acute ischemic stroke. Aim: To evaluate the relationship between hepatic fibrosis and the severity at admission and in-hospital outcome of acute ischemic stroke. Patients and methods: We prospectively studied all patients who were admitted to our department with acute ischemic stroke between September 2010 and February 2018 (n = 1107; 42.1% males, age 79.8 ± 7.2 years). The severity of stroke was assessed at admission with the National Institutes of Health Stroke Scale (NIHSS). Severe stroke was defined as NIHSS ≥ 21. The presence of hepatic fibrosis was evaluated with the Fibrosis-4 index (FIB-4). The outcome was assessed with dependency at discharge (modified Rankin Scale between 2 and 5) and with in-hospital mortality. Results: Patients with severe stroke had a higher FIB-4 index than patients with non-severe stroke (2.7 ± 1.7 and 2.3 ± 1.4, respectively; p < 0.05). Independent risk factors for severe IS were age (relative risk (RR) 1.064, 95% confidence interval (CI) 1.030–1.100, p < 0.001), female sex (RR 1.723, 95% CI 1.100–2.698, p = 0.012), atrial fibrillation (RR 1.869, 95% CI 1.234–2.831, p = 0.002), diastolic blood pressure (DBP) (RR 1.019, 95% CI 1.006–1.033, p = 0.001), and the FIB-4 index (RR 1.130, 95% CI 1.007–1.268, p = 0.022). At discharge, 64.2% of patients were dependent. The FIB-4 index did not differ between patients who were dependent and those who were independent at the time of discharge (2.3 ± 1.5 and 2.1 ± 1.2, respectively; p = 0.061). During hospitalization, 9.8% of patients died. Patients who died during hospitalization had a higher FIB-4 index than those who were discharged (2.9 ± 1.8 and 2.3 ± 1.4, respectively; p < 0.005). Independent risk factors for in-hospital mortality were DBP (RR 1.022, 95% CI 1.010–1.034, p < 0.001), serum glucose levels (RR 1.004, 95% CI 1.001–1.007, p = 0.007), serum triglyceride levels (RR 0.993, 95% CI 0.987–0.999, p = 0.023), NIHSS (RR 1.120, 95% CI 1.092–1.149, p < 0.001), and the FIB-4 index (RR 1.169, 95% CI 1.060–1.289, p = 0.002). Conclusions: Hepatic fibrosis, evaluated with the FIB-4 index, appears to be associated with more severe ischemic stroke and might also represent an independent risk factor for in-hospital mortality in patients admitted with acute ischemic stroke.

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“…Severe stroke, accounting for 12%‐55% of all acute strokes, 1‐5 often leads to major neurological deficits and even death. High blood pressure (BP) was found to contribute to worse outcome in acute severe stroke 5‐7 .…”

Section: Introductionmentioning

confidence: 99%

Blood pressure variability and outcome in acute severe stroke: A post hoc analysis of CHASE—A randomized controlled trial

Zhao

Yuan

et al. 2020

J of Clinical Hypertension

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The influence of blood pressure variability (BPV) on outcomes in patients with severe stroke is still largely unsettled. Using the data of CHASE trial, the authors calculated the BPV during the acute phase and subacute phase of severe stroke, respectively. The primary outcome was to investigate the relationship between BPV and 90‐day modified Rankin scale (mRS) ≥ 3. The BPV was assessed by eight measurements including standard deviation (SD), mean, maximum, minimum, coefficient of variation (CV), successive variation (SV), functional successive variation (FSV), and average real variability (ARV). Then, the SD of SBP was divided into quintiles and compared the quintile using logistic regression in three models. The acute phase included 442 patients, and the subacute phase included 390 patients. After adjustment, six measurements of BPV during the subacute phase rather than acute phase were strongly correlated with outcomes including minimum (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.69‐0.99, p = .037), SD (OR: 1.10, 95% CI: 1.03‐1.17, p = .007), CV (OR: 1.12, 95% CI: 1.03‐1.23, p = .012), ARV (OR: 1.13, 95% CI: 1.05‐1.20, p < .001), SV (OR: 1.09, 95% CI: 1.04‐1.15, p = .001), and FSV (OR: 1.12, 95% CI: 1.05‐1.19, p = .001). In the logistic regression, the highest fifth of SD of SBP predicted poor outcome in all three models. In conclusion, the increased BPV was strongly correlated with poor outcomes in the subacute phase of severe stroke, and the magnitude of association was progressively increased when the SD of BP was above 12.

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Left ventricular hypertrophy assessed by electrocardiogram is associated with more severe stroke and with higher in-hospital mortality in patients with acute ischemic stroke

Cited by 7 publications

References 41 publications

Red cell distribution width is associated with stroke severity and unfavorable functional outcomes in ischemic stroke

Red cell distribution width is associated with stroke severity and unfavorable functional outcomes in ischemic stroke

Hepatic Fibrosis Is a Risk Factor for Greater Severity and Worse Outcome of Acute Ischemic Stroke

Blood pressure variability and outcome in acute severe stroke: A post hoc analysis of CHASE—A randomized controlled trial

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