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ETIOLOGY AND SECONDARY PREVENTION OF ACUTE ISCHEMIC STROKE IN PATIENTS WITH HEART FAILURE

Bernd Kallmu00fcnzerG. SiedlerK. SommerM. ArnoldT. EngelhornK. MachaL. BreuerS. Schwab

出版	Morressier, 2017
URL	http://books.google.com.hk/books?id=uzi6zQEACAAJ&hl=&source=gbs_api

註釋Background: Heart failure (HF) is highly prevalent among patients with acute ischemic stroke. Stroke etiology is referred to cardioembolism with presumed atrial or ventricular origin in most cases. However, heart failure can be transient and concurrent causes of stroke might remain undetected. Methods: Clinical cohort study among patients with ischemic stroke and acute recanalising therapies between 2006 and 2016 at a universitary stroke center.Results: 1209 patients with acute ischemic stroke undergoing intravenous thrombolysis and/or mechanical recanalization were included. HF was present in 378 patients (31%) and showed to be an independent predictor of unfavorable outcome. 32% had the diagnosis of HF established prior to hospital admission for stroke. The medical treatment regimen for HF was consistent with the recommendations of international guidelines in only 53%. 207/378 patients (55%) used anti-platelet therapy and 50 patients (13%) used oral anticoagulation. In 61% ischemic stroke was considered to be of cardioembolic origin (atrial fibrillation: 56%). In 10% another determined etiology of stroke was present: 8% macroangiopathy with high-grade arterial stenosis, 1% microangiopathy and 1% other etiologies. The etiology remained undetermined in 29%. In patients without HF, the rate of unknown causes (45%) was higher and cardioembolic origin less common (35%, p