Author + information
- Si-Hyuck Kang,
- Joonghee Kim,
- Jin-Joo Park,
- Il-Young Oh,
- Chang-Hwan Yoon,
- Kyuseok Kim and
- Dong-Ju Choi
Background: Heart failure (HF) has been associated with an increased risk for ischemic stroke. However, there are limited data regarding stroke risk among patients with HF and sinus rhythm. This population-based study estimated the risk of stroke and thromboembolism for patients with HF in the context of the general population, especially compared to those with atrial fibrillation (AF).
Methods: Data of patients discharged alive from 2003 to 2012 were extracted from the National Health Insurance Corporation sample cohort. Subjects were classified according to HF and AF: control (n=90,277), HF (n=4,533), AF (n=1,187), and HF plus AF (n=1,213) groups. The main outcome was ischemic stroke.
Results: HF was associated with an increased risk for ischemic stroke, which was significant after various adjustment models. Annualized stroke risk was 0.54 (0.52-0.57) per 100 person-years for the control group, 2.00 (1.79-2.21) for the HF group, 2.27 (1.84-2.69) for the AF group, and 2.87 (2.38-3.36) for the HF plus AF group. Advanced age, hypertension, diabetes, and previous stroke or thromboembolism were significant risk factors for ischemic stroke among HF patients. The CHA2DS2-VASc scoring schema had a moderate discriminatory value for stroke risk in patients with HF as well as in AF. The risk of stroke for the HF group was comparable to that of the AF group when stratified according to the CHA2DS2-VASc scores. Those with CHA2DS2-VASc score of 0 or 1 were at low risk for stroke and thromboembolism in the HF plus AF group.
Conclusions: Patients with HF are at increased risk for ischemic stroke and thromboembolism regardless of the presence of AF. This study showed that the CHA2DS2-VASc schema can help stratify stroke risk for individual HF patients. Stroke is a frequent complication among patients with HF; therefore, safe and effective strategies to prevent stroke are needed.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Emerging Developments in HFpEF and Arryhthmias
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1250-288
- 2017 American College of Cardiology Foundation