- 作者：Vanessa Palumbo ; Samuele Baldasseroni ; Patrizia Nencini ; Giovanni Pracucci ; Francesco Arba ; Benedetta Piccardi ; Giosafat Andrea Marella ; Mauro Di Bari ; Gian Franco Gensini ; Niccol¨° Marchionni ; Domenico Inzitari
- 关键词：Heart failure ; Acute ischemic stroke ; Thrombolysis ; Prognosis
- 刊名：European Journal of Internal Medicine
- 出版年：2012
- 出版时间：September, 2012
- 年：2012
- 卷：23
- 期：6
- 页码：552-557
- 全文大小：302 K
Background
Thrombolysis in ischemic stroke reduces disability but not mortality. Our aim was to evaluate the predictivity of heart failure (HF) diagnosis on 90-day mortality and disability in stroke patients undergoing thrombolysis.Material and methods
Hospital records of all consecutive stroke patients treated with thrombolysis at our University Hospital were reviewed. Clinical assessment for HF and echocardiogram were available for all patients according to the thrombolysis institutional protocol. History of HF, LVEF < 40 % , or BOSTON score ¡Ý 5 were tested as predictors.
Results
Of 130 patients (age 66 ¡À 14 years, 64.6 % males, baseline NIHSS 15.6 ¡À 8.8), 17 (13.1 % ) had a history of HF, 16 (12.7 % ) a BOSTON score ¡Ý 5, 13 (10.9 % ) a LVEF < 40 % and 24 (19.0 % ) met clinical criteria for HF diagnosis. Ninety-day mortality and incidence of disability were 16.1 % and 36.1 % , respectively. After adjustment for age, sex, baseline stroke severity and pre-stroke disability, LVEF < 40 % and clinical diagnosis of HF were predictors of 90-day mortality, (p = 0.007 and p = 0.037, respectively).
Conclusion
Clinical diagnosis of HF predicts mortality, but not disability, in acute stroke patients undergoing thrombolysis. Unlike anamnestic record of HF, clinical evaluation of cardiac function, with estimation of LVEF, predicts mortality.