TY - JOUR
T1 - The coexistence of heart failure predicts short term mortality, but not disability, in patients with acute ischemic stroke treated with thrombolysis
T2 - The Florence area Registry
AU - Palumbo, Vanessa
AU - Baldasseroni, Samuele
AU - Nencini, Patrizia
AU - Pracucci, Giovanni
AU - Arba, Francesco
AU - Piccardi, Benedetta
AU - Marella, Giosafat Andrea
AU - Di Bari, Mauro
AU - Gensini, Gian Franco
AU - Marchionni, Niccolò
AU - Inzitari, Domenico
PY - 2012/9
Y1 - 2012/9
N2 - Background: Thrombolysis in ischemic stroke reduces disability but not mortality. Our aim was to evaluate the predictivity of heart failure (HF) diagnosis on 90-day mortality and disability in stroke patients undergoing thrombolysis. Material and methods: Hospital records of all consecutive stroke patients treated with thrombolysis at our University Hospital were reviewed. Clinical assessment for HF and echocardiogram were available for all patients according to the thrombolysis institutional protocol. History of HF, LVEF <40%, or BOSTON score ≥ 5 were tested as predictors. Results: Of 130 patients (age 66 ± 14 years, 64.6% males, baseline NIHSS 15.6 ± 8.8), 17 (13.1%) had a history of HF, 16 (12.7%) a BOSTON score ≥ 5, 13 (10.9%) a LVEF <40% and 24 (19.0%) met clinical criteria for HF diagnosis. Ninety-day mortality and incidence of disability were 16.1% and 36.1%, respectively. After adjustment for age, sex, baseline stroke severity and pre-stroke disability, LVEF <40% and clinical diagnosis of HF were predictors of 90-day mortality, (p = 0.007 and p = 0.037, respectively). Conclusion: Clinical diagnosis of HF predicts mortality, but not disability, in acute stroke patients undergoing thrombolysis. Unlike anamnestic record of HF, clinical evaluation of cardiac function, with estimation of LVEF, predicts mortality.
AB - Background: Thrombolysis in ischemic stroke reduces disability but not mortality. Our aim was to evaluate the predictivity of heart failure (HF) diagnosis on 90-day mortality and disability in stroke patients undergoing thrombolysis. Material and methods: Hospital records of all consecutive stroke patients treated with thrombolysis at our University Hospital were reviewed. Clinical assessment for HF and echocardiogram were available for all patients according to the thrombolysis institutional protocol. History of HF, LVEF <40%, or BOSTON score ≥ 5 were tested as predictors. Results: Of 130 patients (age 66 ± 14 years, 64.6% males, baseline NIHSS 15.6 ± 8.8), 17 (13.1%) had a history of HF, 16 (12.7%) a BOSTON score ≥ 5, 13 (10.9%) a LVEF <40% and 24 (19.0%) met clinical criteria for HF diagnosis. Ninety-day mortality and incidence of disability were 16.1% and 36.1%, respectively. After adjustment for age, sex, baseline stroke severity and pre-stroke disability, LVEF <40% and clinical diagnosis of HF were predictors of 90-day mortality, (p = 0.007 and p = 0.037, respectively). Conclusion: Clinical diagnosis of HF predicts mortality, but not disability, in acute stroke patients undergoing thrombolysis. Unlike anamnestic record of HF, clinical evaluation of cardiac function, with estimation of LVEF, predicts mortality.
KW - Acute ischemic stroke
KW - Heart failure
KW - Prognosis
KW - Thrombolysis
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U2 - 10.1016/j.ejim.2012.03.015
DO - 10.1016/j.ejim.2012.03.015
M3 - Article
C2 - 22863434
AN - SCOPUS:84864623690
VL - 23
SP - 552
EP - 557
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
SN - 0953-6205
IS - 6
ER -