Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Left Ventricular Ejection Fraction Predicts Poststroke Cardiovascular Events and Mortality in Patients without Atrial Fibrillation and Coronary Heart Disease

  • Lee, Jeong-Yoon (Department of Neurology, Soonchunhyang University School of Medicine) ;
  • Sunwoo, Jun-Sang (Department of Neurology, Soonchunhyang University School of Medicine) ;
  • Kwon, Kyum-Yil (Department of Neurology, Soonchunhyang University School of Medicine) ;
  • Roh, Hakjae (Department of Neurology, Soonchunhyang University School of Medicine) ;
  • Ahn, Moo-Young (Department of Neurology, Soonchunhyang University School of Medicine) ;
  • Lee, Min-Ho (Department of Cardiology, Soonchunhyang University School of Medicine) ;
  • Park, Byoung-Won (Department of Cardiology, Soonchunhyang University School of Medicine) ;
  • Hyon, Min Su (Department of Cardiology, Soonchunhyang University School of Medicine) ;
  • Lee, Kyung Bok (Department of Neurology, Soonchunhyang University School of Medicine)
  • Received : 2018.04.05
  • Accepted : 2018.07.24
  • Published : 2018.12.31
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Abstract

Background and Objectives: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). Methods: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. Results: The mean follow-up time was $259.9{\pm}148.8days$ with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF (<55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36-0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39-0.97, p=0.037) for all-cause mortality. Conclusions: LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.

Keywords

Acknowledgement

Supported by : CJ Healthcare Corp.

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