J Clin Neurol.  2021 Apr;17(2):200-205. 10.3988/jcn.2021.17.2.200.

Association between Heart Failure and Clinical Prognosis in Patients with Acute Ischemic Stroke: A Retrospective Cohort Study

• Villanueva JLL
• Torres Zafra JF
• Muñoz FC
• Mendoza Beltrán FdC
• Casas JCS
• Pedraza LAB

• KMID: 2514564
• DOI: http://doi.org/10.3988/jcn.2021.17.2.200

Abstract

Background and Purpose
Ischemic stroke is a common cause of death worldwide. In clinical practice it is observed that many individuals who have experienced an ischemic stroke also suffer from simultaneous comorbidities such as heart failure, which could be directly associated with a worse clinical prognosis. Therefore, this study analyzed outcomes in terms of the severity of the event, inhospital mortality, duration of hospital stay, and inhospital recurrence of the episode, in order to determine the implications resulting from the presentation of both pathologies.
Methods
This was a retrospective-cohort, hospital-based study.
Results
The study included 110 subjects with heart failure (exposed) and 109 subjects without heart failure (nonexposed). The incidence of inhospital mortality was 27.27% in exposed patients and 9.17% in nonexposed patients (p<0.001), and the presence of heart failure increased the risk of death by 92% (p=0.027). According to scores on the National Institutes of Health Stroke Scale, the median severity was worse in exposed than nonexposed patients (16.1 vs. 9.2, p=0.001). The median hospital stay was 9 days in subjects with heart failure and 7 days in nonexposed patients (p=0.011). The rate of inhospital stroke did not differ significantly between exposed and nonexposed patients (1.82% vs. 0.92%, p=0.566).
Conclusions
Individuals with heart failure who suffer from an acute ischemic stroke show worse clinical outcomes in terms of mortality, event severity, and duration of hospital stay.

Keyword

stroke; heart failure; mortality; prognosis