Key result
Among patients with chronic heart failure, the pooled prevalence of ischemic stroke was 4.06%, while the prevalence of white matter hyperintensities and silent brain infarcts was 15.67% and 23.45%, respectively.
Why the study?
Heart failure is linked to ischemic stroke, but studies on the prevalence of ischemic stroke, white matter hyperintensities, silent brain infarcts, and their interaction with ejection fraction remain limited.
Meta-Analysis (n=870,002)
Patients with chronic heart failure have a high prevalence of ischemic stroke, silent brain infarcts, and white matter hyperintensities, highlighting the need for early screening and intervention.
May prompt earlier stroke risk assessment in chronic HF; extends pooled evidence on silent cerebrovascular injury burden.
Introduction: Heart failure (HF) is associated with ischemic stroke (IS). However, there are limited studies on the prevalence of IS, white matter hyperintensities (WMHs), and silent brain infarcts (SBIs). Furthermore, interaction with ejection fraction (EF) is unclear. Methods: statistic. Meta-regression was used for subgroup analysis. Results: In total, 41 articles involving 870,002 patients were retrieved from 15,267 records. Among patients with HF, the pooled proportion of IS was 4.06% (95% CI: 2.94-5.59), and that of WMHs and SBIs was higher at 15.67% (95% CI: 4.11-44.63) and 23.45% (95% CI: 14.53-35.58), respectively. Subgroup analysis of HFpEF and HFrEF revealed a pooled prevalence of 2.97% (95% CI: 2.01-4.39) and 3.69% (95% CI: 2.34-5.77), respectively. Subgroup analysis of WMH Fazekas scores 1, 2, and 3 revealed a decreasing trend from 60.57 % (95% CI: 35.13-81.33) to 11.57% (95% CI: 10.40-12.85) to 3.07% (95% CI: 0.95-9.47). The relative risk and hazard ratio of patients with HF developing IS were 2.29 (95% CI: 1.43-3.68) and 1.63 (95% CI: 1.22-2.18), respectively. Meta-regression showed IS prevalence was positively correlated with decreasing anticoagulant usage. Conclusion: We obtained estimates for the prevalence of IS, WMH, and SBI in HF from systematic review of the literature. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=255126, PROSPERO [CRD42021255126].
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Tan et al. (2022) conducted a meta-analysis in Chronic heart failure (n=870,002). Chronic heart failure was evaluated on Pooled prevalence of ischemic stroke (95% CI 2.94-5.59). Among patients with chronic heart failure, the pooled prevalence of ischemic stroke was 4.06%, while the prevalence of white matter hyperintensities and silent brain infarcts was 15.67% and 23.45%, respectively.
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