Mechanical thrombectomy in patients with heart failure: the Italian registry of Endovascular Treatment in Acute Stroke.

Autor: Gentile L; Department of Neurology and Metropolitan Stroke Center, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Maggiore Hospital, Bologna, Italy.; Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy., Pracucci G; Department of NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy., Saia V; Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure, Italy., Falcou A; Emergency Department, Stroke Unit, Policlinico Umberto I Hospital, Rome, Italy., Biraschi F; Department of Human Neurosciences, Interventional Neuroradiology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy., Zini A; Department of Neurology and Metropolitan Stroke Center, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Maggiore Hospital, Bologna, Italy., Simonetti L; Neuroradiology Department, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Maggiore Hospital, Bologna, Italy., Riva L; Cardiology Unit, Maggiore Hospital, Bologna, Italy., Bigliardi G; Stroke Unit, Neurology Unit, Department of Neuroscience, Azienda Ospedaliera Universitaria Di Modena, Ospedale Civile Baggiovara, Modena, Italy., Vallone S; Neuroradiology Unit, Ospedale Civile Di Baggiovara, Azienda Ospedaliera Universitaria Di Modena, Modena, Italy., Nencini P; Department of NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy., Limbucci N; Department of Interventional Neuroradiology, Careggi University Hospital, Florence, Italy., Diomedi M; Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Rome, Italy., Da Ros V; Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy., Longoni M; Department of Neurology and Stroke Unit Cesena-Forlì, Bufalini Hospital, AUSL Romagna, Cesena, Italy., Ruggiero M; Neuroradiology Unit, Bufalini Hospital, AUSL Romagna, Cesena, Italy., Tassinari T; Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure, Italy., Allegretti L; Department of Interventional Neuroradiology, Santa Corona Hospital, Pietra Ligure, Italy., Cerrato P; Stroke Unit, AOU Città Della Salute E Della Scienza, Molinette Hospital, Turin, Italy., Rubino E; Stroke Unit, AOU Città Della Salute E Della Scienza, Molinette Hospital, Turin, Italy., Bergui M; Neuroscience Department, University of Torino, Turin, Italy., Cavallo R; Neurology Unit, San Giovanni Bosco Hospital, Turin, Italy., Naldi A; Neurology Unit, San Giovanni Bosco Hospital, Turin, Italy., Comelli C; Interventional Neuroradiology Unit, San Giovanni Bosco Hospital, Turin, Italy., Cappellari M; Stroke Unit, Department of Neuroscience, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., Zivelonghi C; Stroke Unit, Department of Neuroscience, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., Plebani M; Interventional Neurovascular Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., De Vito A; Neurology Unit, University Hospital Arcispedale S. Anna, Ferrara, Italy., Merli N; Neurology Unit, University Hospital Arcispedale S. Anna, Ferrara, Italy., Saletti A; Department of Radiology, Neuroradiology Unit, Azienda Ospedaliera Universitaria, Arcispedale S. Anna, Ferrara, Italy., Musolino RF; Department of Clinical and Experimental Medicine, U.O.S.D. Stroke Unit, AOU Policlinico G. Martino, University of Messina, Messina, Italy., Ferraù L; Department of Clinical and Experimental Medicine, U.O.S.D. Stroke Unit, AOU Policlinico G. Martino, University of Messina, Messina, Italy., Vinci SL; Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, Neuroradiology Unit, University of Messina, Messina, Italy., Sacco S; Stroke Unit and Neurology Unit, S.S. Filippo and Nicola Hospital, Avezzano, Italy., Orlandi B; Stroke Unit and Neurology Unit, S.S. Filippo and Nicola Hospital, Avezzano, Italy., De Santis F; Stroke Unit and Neurology Unit, S.S. Filippo and Nicola Hospital, Avezzano, Italy., Filauri P; Neuroradiology Unit, SS. Filippo and Nicola Hospital, Avezzano, Italy., Ruiz L; Stroke Unit, SS. Antonio E Biagio E Cesare Arrigo Hospital, Alessandria, Italy., Sepe FN; Stroke Unit, SS. Antonio E Biagio E Cesare Arrigo Hospital, Alessandria, Italy., Gallesio I; Neuroradiology Unit, SS. Antonio E Biagio E Cesare Arrigo Hospital, Alessandria, Italy., Petruzzellis M; Neurology Unit and Stroke Unit, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy., Chiumarulo L; Neuroradiology Unit, University of Bari, Bari, Italy., Sangalli D; Stroke Unit, Alessandro Manzoni Hospital, ASST Lecco, Italy., Salmaggi A; Stroke Unit, Alessandro Manzoni Hospital, ASST Lecco, Italy., Filizzolo M; Interventional Neuroradiology Unit, AOOR Villa Sofia-Cervello, Palermo, Italy., Moller J; Stroke Unit, G. Brotzu Hospital, Cagliari, Italy., Melis M; Stroke Unit, G. Brotzu Hospital, Cagliari, Italy., Comelli S; Vascular and Interventional Neuroradiology Department, ARNAS G. Brotzu, Cagliari, Italy., Magoni M; Stroke Unit, SpedaliCivili, Vascular Neurology, Brescia, Italy., Gilberti N; Stroke Unit, SpedaliCivili, Vascular Neurology, Brescia, Italy., Gasparotti R; Neuroradiology Unit, Spedali Civili, Brescia, Italy., Invernizzi P; Neurology Unit, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy., Pavia M; Neuroradiology Unit, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy., Pinto V; Neurology and Stroke Unit, Perrino Hospital, Brindisi, Italy., Laspada S; Neurology and Stroke Unit, Perrino Hospital, Brindisi, Italy., Marcheselli S; Stroke Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy., Ajello D; Neuroradiology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy., Viaro F; Stroke Unit and Neurosonology Laboratory, Padua University Hospital, Padua, Italy., Baracchini C; Stroke Unit and Neurosonology Laboratory, Padua University Hospital, Padua, Italy., Causin F; Department of Diagnostic Imaging and Interventional Radiology, Neuroradiology, Padua University Hospital, Padua, Italy., Giannini N; Department Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Di Pisa, Pisa, Italy., Caselli MC; Department Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Di Pisa, Pisa, Italy., Mancuso M; Department Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Di Pisa, Pisa, Italy., Cosottini M; Department of Translational Research and New Technology in Medicine and Surgery, Azienda Ospedaliera Universitaria Di Pisa, Pisa, Italy., Scoditti U; Stroke Unit, Neurology Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy., Menozzi R; Neuroradiology Unit, University Hospital of Parma, Parma, Italy., Russo M; Stroke Unit, Ospedale S. Maria Misericordia, Rovigo, Italy., Amistá P; Neuroradiology Unit, Ospedale S. Maria Misericordia, Rovigo, Italy., Napoletano R; Stroke Unit, S. Giovanni Di Dio E Ruggi d'Aragona Hospital, Salerno, Italy., Romano DG; Unita Operativa Radiologia Vascolare, S. Giovanni Di Dio E Ruggi d'Aragona Hospital, Salerno, Italy., Tassi R; Stroke Unit, Department of Emergency and Transplantation, Azienda Ospedaliera Universitaria Senese, Policlinico 'Santa Maria Alle Scotte', Siena, Italy., Bracco S; UO Neurointerventistica, Azienda Ospedaliera Universitaria Senese, Policlinico 'Santa Maria Alle Scotte', Siena, Italy., Carimati F; Department of Neurology and Stroke Unit, Circolo e Fondazione Macchi Hospital, ASST Settelaghi, Varese, Italy., Versino M; Department of Neurology and Stroke Unit, Circolo e Fondazione Macchi Hospital, ASST Settelaghi, Varese, Italy., Giorgianni A; Neuroradiology Department, Circolo e Fondazione Macchi Hospital, ASST Settelaghi, Varese, Italy., De Boni A; Department of Neurology, San Bortolo Hospital, Vicenza, Italy., Fasano A; Department of Neurology, Vito Fazzi Hospital, Lecce, Italy., Barbarini L; Department of Neurology, Vito Fazzi Hospital, Lecce, Italy., Paladini A; Department of Neuroradiology, Vito Fazzi Hospital, Lecce, Italy., Franchini E; Department of Neurology and Stroke Unit, Bolzano Central Hospital, Bolzano, Italy., Dall'Ora E; Department of Neurology and Stroke Unit, Bolzano Central Hospital, Bolzano, Italy., Comai A; Neuroradiology Unit, Bolzano Central Hospital, Bolzano, Italy., Giovanni F; Department of Neurology and Stroke Unit, Catholic University, Rome, Italy., Pedicelli A; Dipartimento Di Diagnostica Per Immagini, UOSA Neuroradiologia Interventistica, RadioterapiaOncologica Ed Ematologia, Fondazione PoliclinicoUniversitarioA.Gemelli Di Roma, Rome, Italy., Sallustio F; Unitá Di Trattamento Neurovascolare, Ospedale Dei Castelli-ASL6, Rome, Italy., Casetta I; Neurology Unit, University Hospital Arcispedale S. Anna, Ferrara, Italy., Fainardi E; Dipartimento Di Scienze Biomediche, Sperimentali E Cliniche, Università Degli Studi Di Firenze, Ospedale Universitario Careggi, NeuroradiologiaFlorence, Italy., Mangiafico S; Interventional Neuroradiology Consultant at IRCCS NeuromedPozzilli (IS), and Adjunct Professor of Interventional Neuroradiology at Tor Vergata University, Sapienza University and S. Andrea Hospital, Rome, Italy., Toni D; Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy. danilo.toni@uniroma1.it.; Emergency Department, Stroke Unit, Policlinico Umberto I Hospital, Rome, Italy. danilo.toni@uniroma1.it.
Jazyk: angličtina
Zdroj: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2023 Oct; Vol. 44 (10), pp. 3577-3585. Date of Electronic Publication: 2023 May 18.
DOI: 10.1007/s10072-023-06830-9
Abstrakt: Background: Heart failure (HF) is the second most important cardiac risk factor for stroke after atrial fibrillation (AF). Few data are available on mechanical thrombectomy (MT) in acute ischemic stroke (AIS) patients with HF.
Methods: The source of data is the multicentre Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS). All AIS patients ≥ 18 years receiving MT were categorised in two groups: HF and no-HF. Baseline clinical and neuroradiological findings on admission were analysed.
Results: Of 8924 patients, 642 (7.2%) had HF. Compared to the no-HF group, HF patients had higher prevalence of cardiovascular risk factors. Rate of complete recanalisation (TICI 2b-3) was 76.9% in HF vs 78.1% in no-HF group (p = 0.481). Rate of symptomatic intracerebral haemorrhage at 24-h non-contrast computed tomography (NCCT) was 7.6% in HF vs 8.3% in no-HF patients (p = 0.520). At 3 months, 36.4% of HF patients and 48.2% of no-HF patients (p < 0.001) had mRS 0-2, and mortality was, respectively, 30.7% and 18.5% (p < 0.001). In multivariate logistic regression, HF was independently associated with mortality at 3 months (OR 1.53, 1.24-1.88 95% CI, p < 0.001). In multivariate ordinal regression, HF patients had a probability of transitioning to a higher mRS level of 1.23 (1.05-1.44 95% CI, p = 0.012). The propensity score analysis of two groups matched for age, sex, and NIHSS at admission yielded the same results.
Conclusion: MT is safe and effective in HF patients with AIS. Patients with HF and AIS suffered from higher 3-month mortality and unfavourable outcome regardless of acute treatments.
(© 2023. Fondazione Società Italiana di Neurologia.)
Databáze: MEDLINE
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