Stroke–heart syndrome: mechanisms, risk factors, and adverse cardiovascular events

Published Date: 28th June 2023

Publication Authors: Hill AM

Extract
New-onset cardiovascular complications following an ischaemic stroke, hereafter termed stroke–heart syndrome, are a major medical challenge of the 21st century, yet are under-recognized and under-researched.1,2 Acutely, stroke–heart syndrome associates with poorer functional prognosis and increased mortality following stroke.3 In the long term, stroke–heart syndrome associates with significantly higher mortality compared with matched controls.4 Risk factors for stroke and cardiovascular diseases are well documented5 and we have a reasonable understanding of the likely underlying mechanisms of stroke–heart syndrome,6 however, specific risk factors for stroke–heart syndrome and subsequent adverse events have not been previously investigated. Also, whether stroke–heart syndrome impacts males and females differently and whether there are sex-specific risk factors for poor outcomes is unknown. The aim of this study was to investigate the sex-specific incidence of stroke–heart syndrome and 5-year mortality, recurrent stroke, and acute myocardial infarction (AMI) in males and females stratified by different pre-existing cardiovascular risk factors.

This multi-centre cohort study utilized complete case, anonymized data within TriNetX, a global federated health research network with access to electronic medical records (EMRs) from participating academic medical centres, specialty physician practices, and community hospitals, predominantly in the USA. As a federated network, research studies using TriNetX do not require ethical approval or patient informed consent as no identifiable information is received. The TriNetX network was searched on 3 January 2023 and de-identified data sets were analysed that included data from 2002 to 2023 with at least 5 years of follow-up (i.e. index event (incident ischaemic stroke) occurred at least 5 years ago). This study is reported as per the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines (see Supplementary material online, Table S1). More detailed information regarding the online database and methods used can be found within the supplementary file.

 

Buckley, FJR; Hill, A et al. (2023). Stroke–heart syndrome: mechanisms, risk factors, and adverse cardiovascular events. European Journal of Preventive Cardiology. epub 28 June. [Online]. Available at: https://doi.org/10.1093/eurjpc/zwad211 [Accessed 30 October 2023]

 

« Back