Heart complications after a stroke increase the risk of future
cardiovascular events

Date:
March 31, 2022
Source:
American Heart Association
Summary:
A large, observational study found that heart complications
within one month after an ischemic stroke (blocked blood flow to
the brain) are very common. This 'stroke-heart syndrome' may put
stroke survivors at higher risk for death, heart attack or another
stroke within five years.



FULL STORY ========================================================================== People who survive an ischemic stroke are much more likely to develop
major heart complications during the first month after their stroke, and,
as a result, they also have an increased risk of death, heart attack or
another stroke within five years, compared to people who don't develop
heart problems soon after a stroke, according to new research published
today in Stroke, the peer-reviewed, flagship journal of the American
Stroke Association, a division of the American Heart Association.


========================================================================== Ischemic stroke is the most common type of stroke -- accounting for 87% of
all strokes -- and occurs when blood flow to the brain is blocked. After
a stroke, people often have cardiovascular complications, known as
stroke-heart syndrome.

Heart complications include acute coronary syndrome, angina (chest
pain), heart rhythm issues such as atrial fibrillation, arrhythmia
and ventricular fibrillation; heart attack; heart failure or Takotsubo
syndrome (broken heart syndrome), a type of stress-induced temporary enlargement of a part of the heart that impacts its ability to pump effectively. These conditions increase the risk of disability or death
in the short term, yet the long-term consequences for people with
stroke-heart syndrome is unknown.

"We know heart disease and stroke share similar risk factors, and there's
a two-way relationship between the risk of stroke and heart disease. For example, heart conditions such as atrial fibrillation increase the risk
of stroke, and stroke also increases the risk of heart conditions,"
said Benjamin J.R.

Buckley, Ph.D., lead author of the study and a postdoctoral research
fellow in preventive cardiology at the Liverpool Centre for Cardiovascular Science, University of Liverpool in the United Kingdom. "We wanted to know
how common newly diagnosed heart complications are after a stroke and, importantly, whether stroke-heart syndrome is associated with increased
risk of long-term major adverse events." Researchers analyzed the
medical records of more than 365,000 adults treated for ischemic stroke
at more than 50 health care sites predominantly in the United States,
between 2002 and 2021. People who were diagnosed with stroke- heart complications within four weeks after a stroke were matched to an equal
number of stroke survivors who did not have these heart complications
within four weeks (the control group).

After adjusting for potential confounding factors, such as age, sex and
race/ ethnicity, and comparing the stroke survivors who had new heart complications to those who did not, the analysis found:
* Overall, among all stroke survivors in the study, about 1 in 10
(11.1%)
developed acute coronary syndrome, 8.8% were diagnosed with atrial
fibrillation, 6.4% developed heart failure, 1.2% exhibited severe
ventricular arrythmias and 0.1% developed 'broken heart' syndrome
within four weeks after the stroke.

* Risk of death within five years after a stroke significantly
increased
among the participants with new heart complications: 49% more
likely if they had developed acute coronary syndrome; 45% more
likely if they had developed atrial fibrillation/flutter; and 83%
more likely if they developed heart failure. Severe ventricular
arrhythmias doubled the risk of death.

* Chance of hospitalization and heart attack within five years after a
stroke was also significantly higher among those who developed
heart complications within the one-month window.

* Stroke survivors with Takotsubo syndrome were 89% more likely to
have a
major heart event within the five years after their stroke.

* People who developed atrial fibrillation after stroke were 10% more
likely to have a second stroke within five years after their stroke.

* People with stroke and newly diagnosed cardiovascular complications
were
50% more likely to have a recurrent stroke within five years after
the first stroke.

"I was particularly surprised by how common stroke-heart syndrome was
and the high rate of recurrent stroke in all subgroups of adults with stroke-heart syndrome" Buckley said. "This means that this is a high-risk population where we should focus more secondary prevention efforts."
The study's results build on the understanding of the two-way link
between the brain and the heart and extend this understanding to long-term health outcomes.

"We are working on additional research to determine how stroke-heart
syndrome may be better predicted," Buckley said.

"We also need to develop and implement treatments to improve outcomes
for people with stroke-heart syndrome," Buckley said. "For example, comprehensive exercise-based rehabilitation may be helpful after a stroke,
so for people with stroke and newly developed heart complications,
it should also be beneficial, maybe even more so. I think this is an interesting area for future research." Study limitations include that it
is a retrospective analysis and knowing whether the heart complications diagnosed following an ischemic stroke were caused by stroke or rather contributed to the stroke, is unclear.

"This research underscores why it's so important for neurologists and cardiologists to work hand-in-hand with their patients and each other
to understand why the first stroke occurred and perform a comprehensive assessment to identify new risk factors for another stroke and for cardiovascular disease that may require initiation of prevention
therapies," said Lee H. Schwamm, M.D., volunteer chair of the American
Stroke Association Advisory Committee and the C. Miller Fisher Chair
in Vascular Neurology at Massachusetts General Hospital in Boston. "The American Stroke Association recommends a personalized secondary stroke prevention plan for every stroke survivor." Co-authors are Stephanie
L. Harrison, Ph.D.; Andrew Hill, M.B.Ch.B.; Paula Underhill; Deirdre
A. Lane, Ph.D.; and Gregory Y.H. Lip, M.D.


========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Benjamin J.R. Buckley, Stephanie L. Harrison, Andrew Hill, Paula
Underhill, Deirdre A. Lane, Gregory Y.H. Lip. Stroke-Heart Syndrome:
Incidence and Clinical Outcomes of Cardiac Complications Following
Stroke. Stroke, 2022; DOI: 10.1161/STROKEAHA.121.037316 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220331101529.htm

--- up 4 weeks, 3 days, 10 hours, 51 minutes
* Origin: -=> Castle Rock BBS <=- Now Husky HPT Powered! (1:317/3)