Risk of stroke in chronic heart failure patients without atrial fibrillation: analysis of the controlled rosuvastatin in multinational trial heart failure (corona) and the gruppo italiano per lo studio della sopravvivenza nell'insufficienza cardiaca-heart failure (gissi-hf) trials

Abdul-Rahim, A. H. et al. (2015) Risk of stroke in chronic heart failure patients without atrial fibrillation: analysis of the controlled rosuvastatin in multinational trial heart failure (corona) and the gruppo italiano per lo studio della sopravvivenza nell'insufficienza cardiaca-heart failure (gissi-hf) trials. Circulation, 131(17), pp. 1486-1494. (doi:10.1161/CIRCULATIONAHA.114.013760) (PMID:25810334)

Full text not currently available from Enlighten.

Abstract

Background—Our aim was to describe the incidence and predictors of stroke in patients who have heart failure without atrial fibrillation (AF).

Methods and Results—We pooled 2 contemporary heart failure trials, the Controlled Rosuvastatin in Multinational Trial Heart Failure (CORONA) and the Gruppo Italiano per lo Studio della Sopravvivenza nell’Insufficienza cardiaca-Heart Failure trial (GISSI-HF). Of the 9585 total patients, 6054 did not have AF. Stroke occurred in 165 patients (4.7%) with AF and in 206 patients (3.4%) without AF (rates 16.8/1000 patient-years and 11.1/1000 patient-years, respectively). Using Cox proportional-hazards models, we identified the following independent predictors of stroke in patients without AF (ranked by χ2 value): age (hazard ratio, 1.34; 95% confidence interval, 1.18–1.63 per 10 years), New York Heart Association class (1.60, 1.21–2.12 class III/IV versus II), diabetes mellitus treated with insulin (1.87, 1.22–2.88), body mass index (0.74, 0.60–0.91 per 5 kg/m2 up to 30), and previous stroke (1.81, 1.19–2.74). N-terminal pro B-type natriuretic peptide (available in 2632 patients) was also an independent predictor of stroke (hazard ratio, 1.31; 1.11–1.57 per log unit) when added to this model. With the use of a risk score formulated from these predictors, we found that patients in the upper third of risk had a rate of stroke that approximated the risk in patients with AF.

Conclusions—A small number of demographic and clinical variables identified a subset of patients who have heart failure without AF at a high risk of stroke.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Macisaac, Dr Rachael and Jhund, Dr Pardeep and Perez, Mrs Ana and Lees, Professor Kennedy and McMurray, Professor John and Abdul-Rahim, Dr Azmil
Authors: Abdul-Rahim, A. H., Perez, A.-C., Fulton, R. L., Jhund, P. S., Latini, R., Tognoni, G., Wikstrand, J., Kjekshus, J., Lip, G. Y.H., Maggioni, A. P., Tavazzi, L., Lees, K. R., and McMurray, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Circulation
Publisher:Lippincott Williams & Wilkins
ISSN:0009-7322
ISSN (Online):1524-4539

University Staff: Request a correction | Enlighten Editors: Update this record