Cargando…
Age Stratification in Acute Ischemic Stroke Patients with Heart Failure
Background and Purpose. Heart failure (HF) is considered one of the major risk factors associated with the severity of acute ischemic stroke(AIS). The risk factors associated with stroke severity in AIS with a history of HF is not fully understood. Methods. A prospectively maintained database from c...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821452/ https://www.ncbi.nlm.nih.gov/pubmed/36614839 http://dx.doi.org/10.3390/jcm12010038 |
_version_ | 1784865700249075712 |
---|---|
author | Edrissi, Camron Rathfoot, Chase Knisely, Krista Sanders, Carolyn Breauna Goodwin, Richard Nathaniel, Samuel I. Nathaniel, Thomas |
author_facet | Edrissi, Camron Rathfoot, Chase Knisely, Krista Sanders, Carolyn Breauna Goodwin, Richard Nathaniel, Samuel I. Nathaniel, Thomas |
author_sort | Edrissi, Camron |
collection | PubMed |
description | Background and Purpose. Heart failure (HF) is considered one of the major risk factors associated with the severity of acute ischemic stroke(AIS). The risk factors associated with stroke severity in AIS with a history of HF is not fully understood. Methods. A prospectively maintained database from comprehensive stroke centers in PRISMA Health Upstate Sc, was analyzed for patients with AIS and a history of HF from January 2010 to 30 June 2016. The primary outcome was risk factors associated with a National Institute of Health Stroke Scale score (NIHSS) < 7 indicating lower severity and a score ≥ 7 indicating high severity for 65–74 age category and ≥75 years age category for AIS-HF patients. Univariate analysis was used to determine risk factors based on age categories and stroke severities, while multivariable analysis was used to adjust for the effect of confounding variables. Results: A total 367 AIS-HF patients were identified in this study, 113 patients were between 65–74 years old, while 254 patients were in the ≥75 years old age category. In the adjusted analysis for 65–74 age category, history of smoking (OR = 0.105, 95% Confidence interval (CI): 0.018–0.614, p = 0.012), triglycerides (Odd ratio(OR) = 0.993, 95% (CI): 0.987–0.999, p = 0.019), and International Normalized Ratio (INR) (OR = 0.454, 95% CI: 0.196–1.050, p = 0.045), and direct admission treatment (OR = 0.355, 95% CI: 0.137–0.920, p = 0.033) were associated with a lower stroke severity, elevated heart rate (OR = 1.032, 95% CI: 1.009–1.057, p = 0.007) was associated with a higher stroke severity. For the ≥75 years old age category, previous stroke (OR = 2.297, 95% CI: 1.171–9.852, p = 0.024), peripheral vascular disease (OR = 6.784, 95% CI: 1.242–37.065, p = 0.027), heart rate (OR = 1.035, 95% CI: 1.008–1.063, p = 0.012), and systolic blood pressure (OR = 1.023, 95% CI: 1.005–1.041, p = 0.012) were associated with a higher severe stroke severity. Conclusions: After adjusting for the effect of potential confounders, more risk factors were associated with a high severity of stroke among ≥75 years old compared with 65–74 years old AIS-HF patients. Elevated heart rate was an independent risk factor associated with stroke severity in 65–74 and ≥75 years old AIS-HF patients. Elevated heart rate and other identified risk factors should be managed to reduce stroke severity among elderly AIS-HF patients. |
format | Online Article Text |
id | pubmed-9821452 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98214522023-01-07 Age Stratification in Acute Ischemic Stroke Patients with Heart Failure Edrissi, Camron Rathfoot, Chase Knisely, Krista Sanders, Carolyn Breauna Goodwin, Richard Nathaniel, Samuel I. Nathaniel, Thomas J Clin Med Article Background and Purpose. Heart failure (HF) is considered one of the major risk factors associated with the severity of acute ischemic stroke(AIS). The risk factors associated with stroke severity in AIS with a history of HF is not fully understood. Methods. A prospectively maintained database from comprehensive stroke centers in PRISMA Health Upstate Sc, was analyzed for patients with AIS and a history of HF from January 2010 to 30 June 2016. The primary outcome was risk factors associated with a National Institute of Health Stroke Scale score (NIHSS) < 7 indicating lower severity and a score ≥ 7 indicating high severity for 65–74 age category and ≥75 years age category for AIS-HF patients. Univariate analysis was used to determine risk factors based on age categories and stroke severities, while multivariable analysis was used to adjust for the effect of confounding variables. Results: A total 367 AIS-HF patients were identified in this study, 113 patients were between 65–74 years old, while 254 patients were in the ≥75 years old age category. In the adjusted analysis for 65–74 age category, history of smoking (OR = 0.105, 95% Confidence interval (CI): 0.018–0.614, p = 0.012), triglycerides (Odd ratio(OR) = 0.993, 95% (CI): 0.987–0.999, p = 0.019), and International Normalized Ratio (INR) (OR = 0.454, 95% CI: 0.196–1.050, p = 0.045), and direct admission treatment (OR = 0.355, 95% CI: 0.137–0.920, p = 0.033) were associated with a lower stroke severity, elevated heart rate (OR = 1.032, 95% CI: 1.009–1.057, p = 0.007) was associated with a higher stroke severity. For the ≥75 years old age category, previous stroke (OR = 2.297, 95% CI: 1.171–9.852, p = 0.024), peripheral vascular disease (OR = 6.784, 95% CI: 1.242–37.065, p = 0.027), heart rate (OR = 1.035, 95% CI: 1.008–1.063, p = 0.012), and systolic blood pressure (OR = 1.023, 95% CI: 1.005–1.041, p = 0.012) were associated with a higher severe stroke severity. Conclusions: After adjusting for the effect of potential confounders, more risk factors were associated with a high severity of stroke among ≥75 years old compared with 65–74 years old AIS-HF patients. Elevated heart rate was an independent risk factor associated with stroke severity in 65–74 and ≥75 years old AIS-HF patients. Elevated heart rate and other identified risk factors should be managed to reduce stroke severity among elderly AIS-HF patients. MDPI 2022-12-21 /pmc/articles/PMC9821452/ /pubmed/36614839 http://dx.doi.org/10.3390/jcm12010038 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Edrissi, Camron Rathfoot, Chase Knisely, Krista Sanders, Carolyn Breauna Goodwin, Richard Nathaniel, Samuel I. Nathaniel, Thomas Age Stratification in Acute Ischemic Stroke Patients with Heart Failure |
title | Age Stratification in Acute Ischemic Stroke Patients with Heart Failure |
title_full | Age Stratification in Acute Ischemic Stroke Patients with Heart Failure |
title_fullStr | Age Stratification in Acute Ischemic Stroke Patients with Heart Failure |
title_full_unstemmed | Age Stratification in Acute Ischemic Stroke Patients with Heart Failure |
title_short | Age Stratification in Acute Ischemic Stroke Patients with Heart Failure |
title_sort | age stratification in acute ischemic stroke patients with heart failure |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821452/ https://www.ncbi.nlm.nih.gov/pubmed/36614839 http://dx.doi.org/10.3390/jcm12010038 |
work_keys_str_mv | AT edrissicamron agestratificationinacuteischemicstrokepatientswithheartfailure AT rathfootchase agestratificationinacuteischemicstrokepatientswithheartfailure AT kniselykrista agestratificationinacuteischemicstrokepatientswithheartfailure AT sanderscarolynbreauna agestratificationinacuteischemicstrokepatientswithheartfailure AT goodwinrichard agestratificationinacuteischemicstrokepatientswithheartfailure AT nathanielsamueli agestratificationinacuteischemicstrokepatientswithheartfailure AT nathanielthomas agestratificationinacuteischemicstrokepatientswithheartfailure |