Effect of left ventricular ejection fraction Spectrum on 1-Year mortality in patients with acute ischemic stroke or transient ischemic attack

• Published in: CNS neuroscience & therapeutics Vol. 29; no. 11; pp. 3518 - 3527
• Main Authors: Wei, Na, Wei, Yufei, Nie, Ximing, Liu, Xiran, Xiang, Xianglong, Pan, Yuesong, Meng, Xia, Liu, Liping, Wang, Yongjun
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.11.2023; John Wiley and Sons Inc
• Subjects: Anticoagulants; Body mass index; Cardiac arrhythmia; Cardiomyopathy; Cardiovascular disease; Cerebrovascular disease; Cerebrovascular diseases; Clinical outcomes; Death; Diabetes; Echocardiography; Ejection fraction; Heart attacks; Heart failure; Hospitalization; Hypertension; Ischemia; Kidney diseases; Leukocytes; Mortality; Original; Patients; Regression analysis; Statins; Stroke; Survival; Survival analysis; Transient ischemic attack; Ventricle; China; cardiac function; ejection fraction; ischemic stroke; outcome; survival
• ISSN: 1755-5930; 1755-5949
• DOI: 10.1111/cns.14285

We aimed to investigate the association of the left ventricular ejection fraction (LVEF) spectrum with 1-year clinical outcomes in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA). In a prospective registry for the Third China National Stroke Registry (CNSR-III), AIS or TIA patients with echocardiography records during hospitalization were recruited. All LVEFs were categorized into intervals of 5% in width. The lowest and highest intervals are ≤40% and >70%, respectively. The primary outcome was all-cause death at 1 year. Cox proportional hazards regression analysis was performed to investigate the association between baseline LVEF and clinical outcomes. This analysis included a total of 14,053 patients. In total, 418 patients died during 1-year follow-up. Overall, LVEF ≤60% was associated with a higher risk of all-cause death compared to LVEF >60%, independent of demographic and clinical characteristics (aHR 1.29 [95% CI 1.06-1.58]; p = 0.01). The cumulative incidence of all-cause death was significantly different among the eight LVEF groups that survival declined successively with the decrease of LVEF (log-rank p ≤ 0.0001). Patients with AIS or TIA with decreased LVEF (≤60%) had a lower 1-year survival rate after onset. LVEF 50%-60% even within the normal range, may still contribute to poor outcomes in AIS or TIA. Comprehensive evaluation of cardiac function after acute ischemic cerebrovascular disease should be strengthened.