The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction-Reference-Cited by-同舟云学术

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

Published:2023-05-30 Issue:3 Volume:8 Page:731-737
ISSN:2396-9873
Container-title:European Stroke Journal
language:en
Short-container-title:European Stroke Journal

Author:

,Paciaroni Maurizio¹,Agnelli Giancarlo¹,Caso Valeria¹,Becattini Cecilia¹,Mosconi Maria Giulia¹,Giustozzi Michela¹,Tsivgoulis Georgios²,Seiffge David Julian³⁴,Engelter Stefan T.³,Lyrer Philippe³,Polymeris Alexandros A.³,Dittrich Tolga³,Zietz Annaelle³,Putaala Jukka⁵,Strbian Daniel⁵,Tomppo Liisa⁵,Michel Patrik⁶,Strambo Davide⁶,Salerno Alexander⁶,Remillard Suzette⁶,Buehrer Manuela⁶,Bavaud Odessa⁶,Vanacker Peter⁷⁸⁹,Zuurbier Susanna M.⁷⁸,Yperzeele Laetitia⁷⁸,Loos Caroline M.J.⁷⁸,Cappellari Manuel¹⁰,Emiliani Andrea¹⁰,Zedde Marialuisa¹¹,Abdul-Rahim Azmil H.¹²¹³,Dawson Jesse¹³,Cronshaw Robert¹³,Schirinzi Erika¹⁴,Del Sette Massimo¹⁴,Stretz Christoph¹⁵,Kala Narendra¹⁵,Reznik Michael¹⁵,Schomer Ashley¹⁵,Mac Grory Brian¹⁵¹⁶,Jayaraman Mahesh¹⁵,Yaghi Shadi¹⁵,Furie Karen L.¹⁵,Masotti Luca¹⁷,Grifoni Elisa¹⁷,Toni Danilo¹⁸,Risitano Angela¹⁸,Falcou Anne¹⁹,Petraglia Luca¹⁸,Lotti Enrico Maria²⁰,Padroni Marina²¹,Pavolucci Lucia²⁰,Lochner Piergiorgio²²,Silvestrelli Giorgio²³,Ciccone Alfonso²³,Alberti Andrea¹,Venti Michele¹,De Magistris Ilaria Leone¹,Cancelloni Virginia¹,Kargiotis Odysseas²⁴,Rocco Alessandro²⁵,Diomedi Marina²⁵,Marcheselli Simona²⁶,Caliandro Pietro²⁷,Zauli Aurelia²⁸,Reale Giuseppe²⁸,Moci Marco²⁸,Antonenko Kateryna⁴²⁹,Rota Eugenia³⁰,Tassinari Tiziana³¹,Saia Valentina³¹,Palmerini Francesco³²,Aridon Paolo³³,Arnao Valentina³⁴,Monaco Serena³⁴,Cottone Salvatore³⁴,Baldi Antonio³⁵,D’Amore Cataldo³⁵,Ageno Walter³⁶,Pegoraro Samuela³⁶,Ntaios George³⁷,Sagris Dimitrios³⁷,Giannopoulos Sotirios³⁸,Kosmidou Maria³⁸,Ntais Evangelos³⁸,Romoli Michele³⁹,Pantoni Leonardo⁴⁰,Rosa Silvia⁴¹,Bertora Pierluigi⁴⁰,Chiti Alberto⁴²,Canavero Isabella⁴³⁴⁴,Saggese Carlo Emanuele⁴⁵,Plocco Maurizio⁴⁵,Giorli Elisa⁴⁶,Palaiodimou Lina²,Bakola Eleni²,Bandini Fabio⁴⁷,Gasparro Antonio⁴⁸,Terruso Valeria⁴⁸,Mannino Marina⁴⁸,Pezzini Alessandro⁴⁹,Morotti Andrea⁴⁹,Magoni Mauro⁴⁹,Ornello Raffaele⁵⁰,Sacco Simona⁵⁰,Popovic Nemanja⁵¹,Scoditti Umberto⁵²,Genovese Antonio⁵²,Denti Licia⁵³,Flomin Yuriy⁵⁴,Mancuso Michelangelo⁵⁵,Ferrari Elena⁵⁵,Caselli Maria Chiara⁵⁵,Ulivi Leonardo⁵⁵,Giannini Nicola⁵⁵,Vadikolias Kostantinos⁵⁶,Liantinioti Chrysoula²,Chondrogianni Maria²,Carletti Monica¹⁰,Karagkiozi Efstathia³⁷,Athanasakis George³⁷,Makaritsis Kostantinos³⁷,Lanari Alessia⁵⁷,Tatlisumak Turgut⁵⁸,Acciarresi Monica⁵⁹,Vannucchi Vieri¹⁶,Lorenzini Gianni⁶⁰,Tassi Rossana⁶¹,Guideri Francesca⁶¹,Acampa Maurizio⁶¹,Martini Giuseppe⁶¹,Sohn Sung-Il⁶²,Mumoli Nicola⁶³,Tadi Prasanna⁶⁴,Letteri Federica¹⁸,Maccarrone Miriam⁶⁵,Galati Franco⁶⁶,Tiseo Cindy⁵⁰,Gourbali Vanessa⁶⁷,Halvatsiotis Panagiotis⁶⁸,Orlandi Giovanni⁵⁵,Giuntini Martina⁴²,Corea Francesco⁵⁹,Bellesini Marta³⁶,Baronello Mario Maimone³⁴,Karapanayiotides Theodore⁶⁹,Rueckert Christina⁷⁰,Csiba Laszló⁷¹,Szabó Lilla⁷¹,Rigatelli Alberto¹⁰,Imberti Davide⁷²,Zabzuni Dorjan⁷²,Pieroni Alessio⁷³,Barlinn Kristian⁷⁴,Pallesen Lars-Peder⁷⁴,Barlinn Jessica⁷⁴,Doronin Boris⁷⁵,Volodina Vera⁷⁵,Deleu Dirk⁷⁶,Bonetti Bruno¹⁰,Porta Cesare⁶³,Gentile Luana¹⁸,Eskandari Ashraf⁶,De Marchis Gian Marco³

Affiliation:

1. Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Italy

2. Second Department of Neurology, “Attikon” University Hospital, National & Kapodistrian University of Athens, School of Medicine, Athens, Greece

3. Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Switzerland

4. Department of Neurology, Inselspital University Hospital and University of Bern, Switzerland

5. Department of Neurology, Helsinki University Hospital and Neurosciences University of Helsinki, Finland

6. Stroke Center, Neurology Service, Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Switzerland

7. NeuroVascular Center and Stroke Unit Antwerp, Department of Neurology, Antwerp University Hospital, Antwerp, Belgium

8. Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium

9. Groeninge Hospital, Kortrijk, Belgium

10. Stroke Unit, DAI di Neuroscienze, Azienda Ospedaliera Universitaria Integrata, Verona, Italy

11. Neurology Unit, AUSL - IRCCS of Reggio Emilia, Italy

12. School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom

13. Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK

14. Struttura Complessa di Neurologia, Ente Ospedaliero Ospedali Galliera, Genoa, Italy

15. Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI, USA

16. Department of Neurology, Duke University School of Medicine, Durham, North Carolina, USA

17. Internal Medicine, San Giuseppe Hospital, Empoli, Italy

18. Department of Human Neurosciences, Sapienza University of Rome, Italy

19. Stroke Unit – Emergency Department, Policlinico Umberto I, Rome, Italy

20. U.O. Neurologia Presidio Ospedaliero di Ravenna Azienda USL della Romagna, Italy

21. Neurology Unit, Azienda Ospedaliero-Universitaria Sant’Anna, Ferrara, Italy

22. Department of Neurology, Saarland University, Medical Center, Homburg, Germany

23. S.C. di Neurologia e S.S. di Stroke Unit, ASST di Mantova, Italy

24. Stroke Unit, Metropolitan Hospital, Piraeus, Greece

25. Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Rome, Italy

26. Humanitas Clinical and Research Center - IRCCS, Rozzano, Milano, Italy

27. Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

28. Department of Geriatrics, Neurosciences and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy

29. Department of Neurology, Bogomolets National Medical University, Kyiv, Ukraine

30. S.C. Neurologia – Stroke Unit, Novi Ligure/Tortona, ASL Alessandria, Italy

31. Department of Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure (Savona), Italy

32. Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy

33. Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Italy

34. Neurologia – Stroke Unit ARNAS Civico, Palermo, Italy

35. Stroke Unit, Ospedale di Portogruaro (Venice), Italy

36. Department of Medicine, University of Insubria, Ospedale di Circolo, Varese, Italy

37. Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece

38. Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece

39. Neurology and Stroke Unit, Department of Neuroscience, Bufalini Hospital, Cesena, Italy

40. 'L. Sacco' Department of Biomedical and Clinical Sciences, University of Milan, Italy

41. Neurology Unit, ASST Fatebenefratelli – Sacco, Milan, Italy

42. Neurologia, Ospedale Apuano, Massa Carrara, Italy

43. Emergency Neurology, IRCCS Casimiro Mondino Foundation, Pavia, Italy

44. Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy

45. Unità di Terapia Neurovascolare. Ospedale "Fabrizio Spaziani", Frosinone, Italy

46. Stroke Unit, Department of Neurology, Sant'Andrea Hospital, La Spezia, Italy

47. Department of Neurology, Ospedale San Paolo, Savona, Italy

48. Neurologia, Ospedali Riuniti, Palermo, Italy

49. Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Italy

50. Neuroscience Section, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.

51. Clinic of Neurology, University Clinical Center of Vòsvodina, University of Novi Sad, Serbia

52. Stroke Unit, Emergency Department, University of Parma, Italy

53. Stroke Unit - Dipartimento Geriatrico Riabilitativo – University of Parma, Italy

54. Stroke and Neurorehabilitation Unit MC ‘Universal Clinic ‘Oberig’ Kyiv, Ukraine

55. Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Italy

56. Department of Neurology, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece

57. Neurology & Stroke Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

58. Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden

59. UO Gravi Cerebrolesioni, San Giovanni Battista Hospital, Foligno, Italy

60. SC Medicina e Chirurgia d’Accettazione e d’Urgenza, Ospedale Lotti Pontedera, Azienda USL Toscana Nordovest

61. Stroke Unit, AOU Senese, Siena, Italy

62. Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea

63. Internal Medicine Unit, Magenta Hospital, ASST Ovest Milanese, Magenta (MI), Italy

64. Program Director for Vascular Neurology (Stroke) Fellowship Program, Stroke/Vascular Neurologist Clinical, Associate Professor of Neurology, ABPN Diplomate, Board Certified in Neurology and Vascular Neurology, Geisinger Health System, USA

65. Neurologia, Azienda Ospedaliera dell’Alto Adige, Italy

66. Stroke Unit, Jazzolino Hospital, Vibo Valentia, Italy

67. Department of Neurology, Evangelismos Hospital, Athens

68. 2nd Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Greece

69. 2nd Department of Neurology, AHEPA University Hospital, Thessaloniki, Greece

70. Abteilung für Neurologie, Oberschwabenklinik gGmbH, Ravensburg, Germany

71. Stroke Unit, University of Debrecen, Hungary

72. Department of Internal Medicine, Ospedale Civile di Piacenza, Italy

73. Stroke Unit, Azienda Ospedaliera Università di Padova, Padova, Italy

74. Department of Neurology, Dresden University Stroke Center, Dresden, Germany

75. Municipal Budgetary Healthcare Institution of Novosibirsk. City Clinical Hospital # 1. Novosibirsk (Russia) at the Novosibirsk State Medical University (Russia)

76. Neurology, Hamad Medical Corporation, Doha, Qatar

Abstract

Background: 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. Methods: 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). Results: 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). Conclusions: 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.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Neurology (clinical)

Link

http://journals.sagepub.com/doi/pdf/10.1177/23969873231177625

Reference21 articles.

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4. Causes of Death and Influencing Factors in Patients With Atrial Fibrillation

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