The coexistence of heart failure predicts short term mortality, but not disability, in patients with acute ischemic stroke treated with thrombolysis: The Florence area Registry
European Journal of Internal Medicine , 08/10/2012
Palumbo V et al. – Clinical diagnosis of heart failure (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.Methods
- Hospital records of all consecutive stroke patients treated with thrombolysis at the 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.
- Of 130 patients (age 66±14years, 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).