Long-Term Prognosis of Combined Chronic Heart Failure and Chronic Renal Dysfunction After Acute Stroke
Year: 2010
Type: article
Study design: Observational Study
Abstract: AIMS: To assess the prevalence of combined chronic heart failure and chronic renal dysfunction (CHF-CRD) in acute stroke patients and to investigate any prognostic significance on long-term outcome. METHODS AND RESULTS: First-ever acute stroke patients (n = 831) were divided into four groups based on the presence of heart failure (HF, NYHA II-IV with or without left ventricular ejection fraction <40%) and/or renal dysfunction (RD, estimated glomerular filtration rate <60 mL/min/1.73 m(2)). Patients with acute kidney injury and/or acute decompensated HF were excluded. Group 1 comprised patients without HF or RD (nHF + nRD), Group 2 patients with RD but no HF (nHF + RD), Group 3 those with HF and no RD (HF + nRD), whereas Group 4 included patients with both HF and RD (HF + RD). HF and RD were independent predictors of mortality at 10 years. Patients in Groups 2, 3, and 4 had an increased probability of death during follow-up compared with Group 1: HR 1.34 (95% CI 1.02-1.77, P < 0.05) for group 2; HR 2.24 (95% CI 1.50-3.36, P < 0.001) for group 3; and HR 3.42 (95% CI 2.36-4.95, P < 0.001) for group 4. Age, history of transient ischaemic attacks and combined HF and RD were independent predictors of new cardiovascular events. When compared with Group 1, patients in Group 2 had an HR of 1.48 (95% CI 1.11-1.98, P < 0.01), those in Group 3 an HR of 2.21 (95% CI 1.48-3.29, P < 0.001), and those in Group 4 an HR of 3.59 (95% CI 2.40-5.39, P < 0.001). CONCLUSION: The combination of CHF-CRD after acute stroke is an independent predictor for mortality and new cardiovascular morbidity over 10 years.
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2031364567