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ToolsPana, Tiberiu A., Mohamed, Mohamed O., Clark, Allan B., Fahy, Eoin, Mamas, Mamas A. and Myint, Phyo K. (2021) Revascularisation therapies improve the outcomes of ischemic stroke patients with atrial fibrillation and heart failure. International Journal of Cardiology, 324. pp. 205-213. ISSN 0167-5273
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Abstract
Background: Atrial fibrillation (AF) and heart failure (HF) carry a poor prognosis in acute ischaemic stroke (AIS). The impact of revascularisation therapies on outcomes in these patients is not fully understood. Method: National Inpatient Sample (NIS) AIS admissions (January 2004–September 2015) were included (n = 4,597,428). Logistic regressions analysed the relationship between exposures (neither AF nor HF-reference, AF-only, HF-only, AF + HF) and outcomes (in-hospital mortality, length-of-stay >median and moderate-to-severe disability on discharge), stratifying by receipt of intravenous thrombolysis (IVT) or endovascular thrombectomy (ET). Results: 69.2% patients had neither AF nor HF, 16.5% had AF-only, 7.5% had HF-only and 6.7% had AF + HF. 5.04% and 0.72% patients underwent IVT and/or ET, respectively. AF-only and HF-only were each associated with 75–85% increase in the odds of in-hospital mortality. AF + HF was associated with greater than two-fold increase in mortality. Patients with AF-only, HF-only or AF + HF undergoing IVT had better or at least similar in-hospital outcomes compared to their counterparts not undergoing IVT, except for prolonged hospitalisation. Patients undergoing ET with AF-only, HF-only or AF + HF had better (in-hospital mortality, discharge disability, all-cause bleeding) or at least similar (length-of-stay) outcomes to their counterparts not undergoing ET. Compared to AIS patients without AF, AF patients had approximately 50% and more than two-fold increases in the likelihood of receiving IVT or ET, respectively. Conclusions: We confirmed the combined and individual impact of co-existing AF or HF on important patient-related outcomes. Revascularisation therapies improve these outcomes significantly in patients with these comorbidities.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | atrial fibrillation,cerebrovascular disease,heart failure,stroke,thrombectomy,thrombolysis,cardiology and cardiovascular medicine ,/dk/atira/pure/subjectarea/asjc/2700/2705 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Medicine and Health Sciences > Research Centres > Population Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 06 Oct 2020 23:59 |
| Last Modified: | 06 Feb 2025 09:24 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/77152 |
| DOI: | 10.1016/j.ijcard.2020.09.076 |
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