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Neurological sciences, 2023-10, Vol.44 (10), p.3577-3585
2023
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Autor(en) / Beteiligte
Titel
Mechanical thrombectomy in patients with heart failure: the Italian registry of Endovascular Treatment in Acute Stroke
Ist Teil von
  • Neurological sciences, 2023-10, Vol.44 (10), p.3577-3585
Ort / Verlag
Cham: Springer International Publishing
Erscheinungsjahr
2023
Quelle
Psychology and Behavioral Sciences Collection
Beschreibungen/Notizen
  • 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.
Sprache
Englisch
Identifikatoren
ISSN: 1590-1874
eISSN: 1590-3478
DOI: 10.1007/s10072-023-06830-9
Titel-ID: cdi_proquest_miscellaneous_2815250409

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