September 24, 2023Open Access

Cardiac complications following cerebrovascular disease

Q: What are the key findings of this study?

Within one year after a cerebrovascular event, new electrocardiographic changes were observed in 81.7% of patients with ischemic stroke, 71.4% with transient ischemic attack, and 55.8% with hemorrhagic stroke.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cerebrovascular disease (n=721). Intervention: Ischemic stroke vs. Hemorrhagic stroke and transient ischemic attack. Primary outcome: New electrocardiographic (ECG) changes within one year (p=<0.001).

Q: What does this research mean for the field?

Within one year after a cerebrovascular event, new electrocardiographic changes are highly frequent, occurring in 81.7% of patients with ischemic stroke, 71.4% with transient ischemic attack, and 55.8% with hemorrhagic stroke, even in those without prior cardiac disease. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Ischemic stroke is linked to new ECG changes in ~82% of patients within one year.

P<0.001
n=721

Why the study?

Cardiac complications after stroke are an important yet understudied manifestation of brain-heart interactions.

Population

721 patients without previous cardiac disease or cardioembolic origin after cerebrovascular events

Comparison

Acute ischemic stroke vs transient ischemic attack vs hemorrhagic stroke

Authors

MRM RohnerUniversity of Zurich CGCathérine GebhardInterventional Cardiology ALAndreas R. LuftGoethe University Frankfurt

Discussion

Member takes

Implication

Frequent new ECG changes after cerebrovascular events may support closer cardiac monitoring; this Level 3 cohort leaves open whether screening improves outcomes.

Study Design

Type

Cohort (n=721)

Multicenter

Structured PICO

Population

721 patients with a first-in-a-lifetime cerebrovascular event (580 ischemic stroke, 98 transient ischemic attack, 43 hemorrhagic stroke) without evidence of previous cardiac disease or presumed cardioembolic origin, who had at least one cardiac check-up within one year.

Intervention

Occurrence of acute cerebrovascular events (ischemic stroke, transient ischemic attack, or hemorrhagic stroke)

Comparator

Comparison between the three cerebrovascular event types (ischemic stroke vs. transient ischemic attack vs. hemorrhagic stroke)

Outcome

New cardiac findings within one year following disease onset, categorized as arrhythmia/electrocardiographic (ECG) changes, myocardial alterations, valvular abnormalities, coronary perfusion insufficiency, and hypotensive/hypertensive blood pressure abnormalities

Main Result

Absolute Event Rate: 81.7% vs 55.8%

p-value: p=<0.001

Cardiac complications, particularly arrhythmias and myocardial alterations, are highly prevalent within the first year after a cerebrovascular event even in patients without prior cardiac disease, highlighting the need for thorough cardiac workup.

Limitations

Different sizes of the three subgroups render statistical comparisons more difficult
Not every finding newly detected during the cardiological check-up was necessarily new
Types of examination performed during cardiological check-ups varied significantly from patient to patient
Selection bias in the hemorrhagic stroke subgroup as a comparatively small portion received cardiac check-ups
Length of follow-up (12 months) might capture non-stroke-related diseases developed independently
Different sizes of the three subgroups
Selection bias (only 37.2% of hemorrhagic stroke patients received cardiac workup compared to 96.1% of ischemic stroke patients)

Cite This Study

Rohner et al. (2023) conducted a cohort in Cerebrovascular disease (n=721). Ischemic stroke vs. Hemorrhagic stroke and transient ischemic attack was evaluated on New electrocardiographic (ECG) changes within one year (p=<0.001). Within one year after a cerebrovascular event, new electrocardiographic changes were observed in 81.7% of patients with ischemic stroke, 71.4% with transient ischemic attack, and 55.8% with hemorrhagic stroke.

synapsesocial.com/papers/6a193eb820fe4b8df388b954 https://doi.org/10.1101/2023.09.21.23295936

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Implication

Frequent new ECG changes after cerebrovascular events may support closer cardiac monitoring; this Level 3 cohort leaves open whether screening improves outcomes.

Cardiac complications following cerebrovascular disease

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Cardiac complications following cerebrovascular disease

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider