کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2701953 1144497 2013 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Identifying a High Stroke Risk Subgroup in Individuals with Heart Failure
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی مغز و اعصاب بالینی
پیش نمایش صفحه اول مقاله
Identifying a High Stroke Risk Subgroup in Individuals with Heart Failure
چکیده انگلیسی

BackgroundHeart failure (HF) is associated with an overall stroke rate that is too low to justify anticoagulation in all patients. This study was conducted to determine if vascular risk factors can identify a subgroup of individuals with heart failure with a stroke rate high enough to warrant anticoagulation.MethodsThe REGARDS study is a population-based cohort of US adults aged ≥45 years. Participants are contacted every 6 months by telephone for self- or proxy-reported stroke and medical records are retrieved and adjudicated by physicians. Participants were characterized into 3 groups: HF without atrial fibrillation (AF), AF with or without HF, and neither HF nor AF. Cardiovascular risk factors at baseline were compared between participants with and without incident stroke in HF and AF. Stroke incidence was assessed in risk factor subgroups in HF participants.ResultsOf the 30,239 participants, those with missing/anomalous data were excluded. Of the remaining 28,832, 1360 (5%) had HF without AF, 2528 (9%) had AF, and 24,944 (86%) had neither. Previous stroke/transient ischemic attack (TIA; P = .0004), diabetes mellitus (DM; P = .03), and higher systolic blood pressure (P = .046) were associated with increased stroke risk in participants with HF without AF. In participants with HF without AF, stroke incidence was highest in those with previous stroke/TIA and DM (2.4 [1.1, 4.0] per 100 person-years).ConclusionsThe combination of previous stroke/TIA and DM increases the incidence of stroke in participants with HF without AF. No analyzed subgroup had a stroke rate high enough to make it likely that the benefits of warfarin would outweigh the risks.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Stroke and Cerebrovascular Diseases - Volume 22, Issue 5, July 2013, Pages 620–626
نویسندگان
, , , , , , , , ,