Effect of left ventricular ejection fraction Spectrum on 1‐Year mortality in patients with acute ischemic stroke or transient ischemic attack

Abstract

AbstractAimsWe aimed to investigate the association of the left ventricular ejection fraction (LVEF) spectrum with 1‐year clinical outcomes in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA).MethodsIn a prospective registry for the Third China National Stroke Registry (CNSR‐III), AIS or TIA patients with echocardiography records during hospitalization were recruited. All LVEFs were categorized into intervals of 5% in width. The lowest and highest intervals are ≤40% and >70%, respectively. The primary outcome was all‐cause death at 1 year. Cox proportional hazards regression analysis was performed to investigate the association between baseline LVEF and clinical outcomes.ResultsThis analysis included a total of 14,053 patients. In total, 418 patients died during 1‐year follow‐up. Overall, LVEF ≤60% was associated with a higher risk of all‐cause death compared to LVEF >60%, independent of demographic and clinical characteristics (aHR 1.29 [95% CI 1.06–1.58]; p = 0.01). The cumulative incidence of all‐cause death was significantly different among the eight LVEF groups that survival declined successively with the decrease of LVEF (log‐rank p ≤ 0.0001).ConclusionsPatients with AIS or TIA with decreased LVEF (≤60%) had a lower 1‐year survival rate after onset. LVEF 50%–60% even within the normal range, may still contribute to poor outcomes in AIS or TIA. Comprehensive evaluation of cardiac function after acute ischemic cerebrovascular disease should be strengthened.