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The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction

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Titel: The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction
Autoren: Paciaroni, M.
Weitere Verfasser: RAF and RENO-EXTEND Investigators, Agnelli, G., Caso, V., Becattini, C., Mosconi, M.G., Giustozzi, M., Tsivgoulis, G., Seiffge, D.J., Engelter, S.T., Lyrer, P., Polymeris, A.A., Dittrich, T., Zietz, A., Putaala, J., Strbian, D., Tomppo, L., Michel, P., Strambo, D., Salerno, A., Remillard, S., Buehrer, M., Bavaud, O., Vanacker, P., Zuurbier, S.M., Yperzeele, L., Loos, C.M., Cappellari, M., Emiliani, A., Zedde, M., Abdul-Rahim, A.H., Dawson, J., Cronshaw, R., Schirinzi, E., Del Sette, M., Stretz, C., Kala, N., Reznik, M., Schomer, A., Mac Grory, B., Jayaraman, M., Yaghi, S., Furie, K.L., Masotti, L., Grifoni, E., Toni, D., Risitano, A., Falcou, A., Petraglia, L., Lotti, E.M., Padroni, M., Pavolucci, L., Lochner, P., Silvestrelli, G., Ciccone, A., Alberti, A., Venti, M., De Magistris, I.L., Cancelloni, V., Kargiotis, O., Rocco, A., Diomedi, M., Marcheselli, S., Caliandro, P., Zauli, A., Reale, G., Moci, M., Antonenko, K., Rota, E., Tassinari, T., Saia, V., Palmerini, F., Aridon, P., Arnao, V., Monaco, S., Cottone, S., Baldi, A., DAmore, C., Ageno, W., Pegoraro, S., Ntaios, G., Sagris, D., Giannopoulos, S., Kosmidou, M., Ntais, E., Romoli, M., Pantoni, L., Rosa, S., Bertora, P., Chiti, A., Canavero, I., Saggese, C.E., Plocco, M., Giorli, E., Palaiodimou, L., Bakola, E., Bandini, F., Gasparro, A., Terruso, V., Mannino, M., Pezzini, A., Morotti, A., Magoni, M., Ornello, R., Sacco, S., Popovic, N., Scoditti, U., Genovese, A., Denti, L., Flomin, Y., Mancuso, M., Ferrari, E., Caselli, M.C., Ulivi, L., Giannini, N., Vadikolias, K., Liantinioti, C., Chondrogianni, M., Carletti, M., Karagkiozi, E., Athanasakis, G., Makaritsis, K., Lanari, A., Tatlisumak, T., Acciarresi, M., Vannucchi, V., Lorenzini, G., Tassi, R., Guideri, F., Acampa, M., Martini, G., Sohn, S.I., Mumoli, N., Tadi, P., Letteri, F., Maccarrone, M., Galati, F., Tiseo, C., Gourbali, V., Halvatsiotis, P., Orlandi, G., Giuntini, M., Corea, F., Bellesini, M., Baronello, M.M., Karapanayiotides, T., Rueckert, C., Csiba, L., Szabó, L., Rigatelli, A., Imberti, D., Zabzuni, D., Pieroni, A., Barlinn, K., Pallesen, L.P., Barlinn, J., Doronin, B., Volodina, V., Deleu, D., Bonetti, B., Porta, C., Gentile, L., Eskandari, A., De Marchis, G.M.
Quelle: European stroke journal, vol. 8, no. 3, pp. 731-737
Verlagsinformationen: 2023.
Publikationsjahr: 2023
Schlagwörter: Humans, Atrial Fibrillation/complications, Prospective Studies, Retrospective Studies, Stroke Volume, Anticoagulants/adverse effects, Stroke/epidemiology, Hemorrhage/chemically induced, Ischemic Stroke/chemically induced, Acute stroke, atrial fibrillation, congestive heart failure
Beschreibung: Atrial fibrillation (AF) and congestive heart failure often coexist due to their shared risk factors leading to potential worse outcome, particularly cerebrovascular events. The aims of this study were to calculate the rates of ischemic and severe bleeding events in ischemic stroke patients having both AF and reduced ejection fraction (rEF) (⩽40%), compared to ischemic stroke patients with AF but without rEF. We performed a retrospective analysis that drew data from prospective studies. The primary outcome was the composite of either ischemic (stroke or systemic embolism), or hemorrhagic events (symptomatic intracranial bleeding and severe extracranial bleeding). The cohort for this analysis comprised 3477 patients with ischemic stroke and AF, of which, 643 (18.3%) had also rEF. After a mean follow-up of 7.5 ± 9.1 months, 375 (10.8%) patients had 382 recorded outcome events, for an annual rate of 18.0%. While the number of primary outcome events in patients with rEF was 86 (13.4%), compared to 289 (10.2%) for the patients without rEF; on multivariable analysis rEF was not associated with the primary outcome (OR 1.25; 95% CI 0.84-1.88). At the end of follow-up, 321 (49.9%) patients with rEF were deceased or disabled (mRS ⩾3), compared with 1145 (40.4%) of those without rEF; on multivariable analysis, rEF was correlated with mortality or disability (OR 1.35; 95% CI 1.03-1.77). In patients with ischemic stroke and AF, the presence of rEF was not associated with the composite outcome of ischemic or hemorrhagic events over short-term follow-up but was associated with increased mortality or disability.
Publikationsart: Article
Dateibeschreibung: application/pdf
Sprache: English
Zugangs-URL: https://serval.unil.ch/resource/serval:BIB_2EE0491CC900.P003/REF.pdf
http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_2EE0491CC9002
https://serval.unil.ch/notice/serval:BIB_2EE0491CC900
Dokumentencode: edsair.od......1900..016832f53aa8911696f46eceb9ebfc32
Datenbank: OpenAIRE
Beschreibung
Abstract:Atrial fibrillation (AF) and congestive heart failure often coexist due to their shared risk factors leading to potential worse outcome, particularly cerebrovascular events. The aims of this study were to calculate the rates of ischemic and severe bleeding events in ischemic stroke patients having both AF and reduced ejection fraction (rEF) (⩽40%), compared to ischemic stroke patients with AF but without rEF. We performed a retrospective analysis that drew data from prospective studies. The primary outcome was the composite of either ischemic (stroke or systemic embolism), or hemorrhagic events (symptomatic intracranial bleeding and severe extracranial bleeding). The cohort for this analysis comprised 3477 patients with ischemic stroke and AF, of which, 643 (18.3%) had also rEF. After a mean follow-up of 7.5 ± 9.1 months, 375 (10.8%) patients had 382 recorded outcome events, for an annual rate of 18.0%. While the number of primary outcome events in patients with rEF was 86 (13.4%), compared to 289 (10.2%) for the patients without rEF; on multivariable analysis rEF was not associated with the primary outcome (OR 1.25; 95% CI 0.84-1.88). At the end of follow-up, 321 (49.9%) patients with rEF were deceased or disabled (mRS ⩾3), compared with 1145 (40.4%) of those without rEF; on multivariable analysis, rEF was correlated with mortality or disability (OR 1.35; 95% CI 1.03-1.77). In patients with ischemic stroke and AF, the presence of rEF was not associated with the composite outcome of ischemic or hemorrhagic events over short-term follow-up but was associated with increased mortality or disability.