Document Detail


Long-term prognosis of combined chronic heart failure and chronic renal dysfunction after acute stroke.
MedLine Citation:
PMID:  20413394     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIMS: To assess the prevalence of combined chronic heart failure and chronic renal dysfunction (CHF-CRD) in acute stroke patients and to investigate any prognostic significance on long-term outcome.
METHODS AND RESULTS: First-ever acute stroke patients (n = 831) were divided into four groups based on the presence of heart failure (HF, NYHA II-IV with or without left ventricular ejection fraction <40%) and/or renal dysfunction (RD, estimated glomerular filtration rate <60 mL/min/1.73 m(2)). Patients with acute kidney injury and/or acute decompensated HF were excluded. Group 1 comprised patients without HF or RD (nHF + nRD), Group 2 patients with RD but no HF (nHF + RD), Group 3 those with HF and no RD (HF + nRD), whereas Group 4 included patients with both HF and RD (HF + RD). HF and RD were independent predictors of mortality at 10 years. Patients in Groups 2, 3, and 4 had an increased probability of death during follow-up compared with Group 1: HR 1.34 (95% CI 1.02-1.77, P < 0.05) for group 2; HR 2.24 (95% CI 1.50-3.36, P < 0.001) for group 3; and HR 3.42 (95% CI 2.36-4.95, P < 0.001) for group 4. Age, history of transient ischaemic attacks and combined HF and RD were independent predictors of new cardiovascular events. When compared with Group 1, patients in Group 2 had an HR of 1.48 (95% CI 1.11-1.98, P < 0.01), those in Group 3 an HR of 2.21 (95% CI 1.48-3.29, P < 0.001), and those in Group 4 an HR of 3.59 (95% CI 2.40-5.39, P < 0.001).
CONCLUSION: The combination of CHF-CRD after acute stroke is an independent predictor for mortality and new cardiovascular morbidity over 10 years.
Authors:
George Tsagalis; Neratzoula Bakirtzi; Konstantinos Spengos; Anastasia Vemmou; Efstathios Manios; Konstantinos Xinos; Konstantinos Vemmos
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Publication Detail:
Type:  Journal Article     Date:  2010-04-22
Journal Detail:
Title:  European journal of heart failure : journal of the Working Group on Heart Failure of the European Society of Cardiology     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  849-54     Citation Subset:  IM    
Affiliation:
Renal Unit, Alexandra Hospital, Athens, Greece. tsagalis@otenet.gr
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