Diastolic Dysfunction and the Risk of Stroke and Major Bleeding.
| Autor: | Kundrick J; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Saba KI; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Naniwadekar A; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Singla V; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Mulukutla S; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Thoma F; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Bhonsale A; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Kancharla K; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Voigt A; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Shalaby AA; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Estes Iii NAM; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Jain S; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA., Saba S; Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA. |
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| Jazyk: | angličtina |
| Zdroj: | Stroke [Stroke] 2024 Dec; Vol. 55 (12), pp. 2856-2862. Date of Electronic Publication: 2024 Nov 11. |
| DOI: | 10.1161/STROKEAHA.124.048287 |
| Abstrakt: | Background: Left ventricular diastolic dysfunction (DD) is associated with adverse cardiovascular outcomes including atrial fibrillation. Whether DD is independently associated with incident stroke and transient ischemic attack (TIA) and with bleeding events is not known. We performed this observational cohort analysis to examine the impact of DD on the risk of stroke/TIA and major bleeding. Methods: Patients who underwent at least 1 cardiac echocardiogram and were followed for at least 3 months were included in this study. Patients with a prior history of stroke, TIA, or major bleeding, as determined by International Classifications of Diseases codes, were excluded. Smart key-phrase search was applied to echocardiographic reports to classify patients into 4 groups based on the most severe DD assessment. Patients in whom the presence of DD could not be determined were excluded. The final study cohort was followed to the end point of hospital admission for stroke/TIA and major bleeding, and independent predictors of these events were evaluated using the multivariable Cox proportional hazards method. Results: The final study cohort (age, 56±18 years; 56% women) had 96 702 patients with no DD and 18 164, 5881, and 1340 patients with DD grades I, II, and III, respectively. Over a median follow-up of 3.4 years, 2938 (2.4%) patients were hospitalized for stroke/TIA and 5567 (4.6%) for major bleeding. After adjusting for age, the CHA Conclusions: DD is independently associated with a higher risk of cerebrovascular accidents and major bleeding. DD should be considered when counseling patients regarding their risk profile and management options. Competing Interests: The authors report receiving compensation for consultation from Boston Scientific (Drs Kancharla, Estes III, and Saba) and Medtronic, Inc (Drs Estes III and Saba) and research support from Varian (Dr Kancharla), Boston Scientific (Drs Jain and Saba), Medtronic (Dr Jain), and Abbott (Dr Saba). The other authors report no conflicts. |
| Databáze: | MEDLINE |
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