The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction
- Autori: Maurizio Paciaroni; Giancarlo Agnelli; Valeria Caso; Cecilia Becattini; Maria Giulia Mosconi; Michela Giustozzi; Georgios Tsivgoulis; David Julian Seiffge; Stefan T. Engelter; Philippe Lyrer; Alexandros A. Polymeris; Tolga Dittrich; Annaelle Zietz; Jukka Putaala; Daniel Strbian; Liisa Tomppo; Patrik Michel; Davide Strambo; Alexander Salerno; Suzette Remillard; Manuela Buehrer; Odessa Bavaud; Peter Vanacker; Susanna M. Zuurbier; Laetitia Yperzeele; Caroline M.J. Loos; Manuel Cappellari; Andrea Emiliani; Marialuisa Zedde; Azmil H. Abdul-Rahim; Jesse Dawson; Robert Cronshaw; Erika Schirinzi; Massimo Del Sette; Christoph Stretz; Narendra Kala; Michael Reznik; Ashley Schomer; Brian Mac Grory; Mahesh Jayaraman; Shadi Yaghi; Karen L. Furie; Luca Masotti; Elisa Grifoni; Danilo Toni; Angela Risitano; Anne Falcou; Luca Petraglia; Enrico Maria Lotti; Marina Padroni; Lucia Pavolucci; Piergiorgio Lochner; Giorgio Silvestrelli; Alfonso Ciccone; Andrea Alberti; Michele Venti; Ilaria Leone De Magistris; Virginia Cancelloni; Odysseas Kargiotis; Alessandro Rocco; Marina Diomedi; Simona Marcheselli; Pietro Caliandro; Aurelia Zauli; Giuseppe Reale; Marco Moci; Kateryna Antonenko; Eugenia Rota; Tiziana Tassinari; Valentina Saia; Francesco Palmerini; Paolo Aridon; Valentina Arnao; Serena Monaco; Salvatore Cottone; Antonio Baldi; Cataldo D’Amore; Walter Ageno; Samuela Pegoraro; George Ntaios; Dimitrios Sagris; Sotirios Giannopoulos; Maria Kosmidou; Evangelos Ntais; Michele Romoli; Leonardo Pantoni; Silvia Rosa; Pierluigi Bertora; Alberto Chiti; Isabella Canavero; Carlo Emanuele Saggese; Maurizio Plocco; Elisa Giorli; Lina Palaiodimou; Eleni Bakola; Fabio Bandini; Antonio Gasparro; Valeria Terruso; Marina Mannino; Alessandro Pezzini; Andrea Morotti; Mauro Magoni; Raffaele Ornello; Simona Sacco; Nemanja Popovic; Umberto Scoditti; Antonio Genovese; Licia Denti; Yuriy Flomin; Michelangelo Mancuso; Elena Ferrari; Maria Chiara Caselli; Leonardo Ulivi; Nicola Giannini; Kostantinos Vadikolias; Chrysoula Liantinioti; Maria Chondrogianni; Monica Carletti; Efstathia Karagkiozi; George Athanasakis; Kostantinos Makaritsis; Alessia Lanari; Turgut Tatlisumak; Monica Acciarresi; Vieri Vannucchi; Gianni Lorenzini; Rossana Tassi; Francesca Guideri; Maurizio Acampa; Giuseppe Martini; Sung-Il Sohn; Nicola Mumoli; Prasanna Tadi; Federica Letteri; Miriam Maccarrone; Franco Galati; Cindy Tiseo; Vanessa Gourbali; Panagiotis Halvatsiotis; Giovanni Orlandi; Martina Giuntini; Francesco Corea; Marta Bellesini; Mario Maimone Baronello; Theodore Karapanayiotides; Christina Rueckert; Laszló Csiba; Lilla Szabó; Alberto Rigatelli; Davide Imberti; Dorjan Zabzuni; Alessio Pieroni; Kristian Barlinn; Lars-Peder Pallesen; Jessica Barlinn; Boris Doronin; Vera Volodina; Dirk Deleu; Bruno Bonetti; Cesare Porta; Luana Gentile; Ashraf Eskandari; Gian Marco De Marchis
- Anno di pubblicazione: 2023
- Tipologia: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/639374
Abstract
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.