Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Int J Cardiol. 2010 Oct 29;144(3):389-93. doi: 10.1016/j.ijcard.2009.04.035. Epub 2009 May 12.

Epidemiology of stroke in chronic heart failure patients with normal sinus rhythm: findings from the DIG stroke sub-study.

Author information

  • 1University of Alabama at Birmingham, 1530 3rd Avenue South, CH-19, Ste-219, Birmingham, AL 35294-2041, USA.

Abstract

BACKGROUND:

Little is known about the epidemiology of stroke in chronic systolic and diastolic heart failure (HF) patients in normal sinus rhythm (NSR) receiving angiotensin-converting enzyme (ACE) inhibitors. Because all HF patients in the Digitalis Investigation Group (DIG) trial (N=7788) were in NSR and nearly all were receiving ACE inhibitors, a survey-based stroke-sub-study was conducted but its findings have never been published.

METHODS:

DIG investigators confirmed a total 222 cases of stroke of which 144 had neurological deficit ≥24 h. We used logistic regression models to determine predictors of incident stroke among all 7788 patients and predictors of neurological deficit ≥24 h and all-cause mortality among 222 stroke patients.

RESULTS:

Age ≥65 years (adjusted odds ratio {AOR}, 1.36; 95% confidence interval {CI}, 1.02-1.80; P=0.035), nonwhite race (AOR, 0.65; 95% CI, 0.42-0.99; P=0.047), hypertension (AOR, 1.46; 95% CI, 1.11-1.94; P=0.008), diabetes mellitus (AOR, 1.37; 95% CI, 1.03-1.82; P=0.030), and cardiomegaly (AOR, 1.39; 95% CI, 1.03-1.86; P=0.030) were independent predictors of stroke. However, among those with stroke, nonwhites had higher odds of neurological deficits ≥24 h (AOR, 2.86; 95% CI, 1.01-8.07; P=0.047) and death (AOR, 3.28; 95% CI, 1.30-8.30; P=0.012).

CONCLUSION:

Older age, hypertension, diabetes and cardiomegaly were associated with increased incidence of stroke among HF patients with NSR receiving ACE inhibitors. The association of race and stroke, however, was complex. While nonwhite race was associated with decreased risk of stroke, among those with stroke, nonwhite race was associated with increased stroke severity and mortality.

Published by Elsevier Ireland Ltd.

PMID:
19439379
[PubMed - indexed for MEDLINE]
PMCID:
PMC2952701
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Write to the Help Desk