Key result
LVEF <48% linked to ~21.3-fold higher risk of neurological deterioration in acute ischemic stroke.
Why the study?
Does a reduced left ventricular ejection fraction (<48%) increase the risk of neurological clinical deterioration in patients hospitalized with acute ischemic stroke?
Cohort (n=62)
No
Does a reduced left ventricular ejection fraction (<48%) increase the risk of neurological clinical deterioration in patients hospitalized with acute ischemic stroke?
Reduced left ventricular ejection fraction (<48%) is strongly associated with worsening neurological deficits in acute ischemic stroke patients, particularly when accompanied by diabetes mellitus and low HDL.
Answers are grounded in this paper and cite their sources.
LVEF <48% may aid risk stratification in acute ischemic stroke; leaves open whether targeted interventions improve outcomes.
Aims: The aim of the study was to determine the effect of left ventricular ejection fraction on clinical outcomes of acute ischemic stroke patients. Study Design: This study design was a prospective cohort observational study. Place and Duration of Study: This study was conducted at Stroke Unit, Neurology Ward, and Cardiology Ward at the Dr. Sardjito Hospital, Yogyakarta, Indonesia, between July and December 2016. Materials and Methods: Hospitalized acute ischemic stroke patients were recruited, with sample was taken by consecutive sampling until reaching amount fulfilling inclusion criterion was 62 persons. In this study, clinical outcomes were measured by National Institutes of Health Stroke Scale (NIHSS) scores as well as dependent variables and left ventricular ejection fraction as independent variables. Logistic regression analyses were performed to discover any potential independent variable that can influence the left ventricular ejection fraction role at the clinical outcomes with NIHSS scores. Results: Multivariate analyses revealed that several variables were significantly interacted with the influence of left ventricular ejection fraction at the clinical outcomes with NIHSS scores. These variables were the left ventricular ejection fraction <48% (95% confidence interval [CI]: 0.691–0.925; P = 0.001), left ventricular ejection fraction + low high-density lipoprotein (HDL) (95% CI: 0.73–0.949; P = 0,001), left ventricular ejection fraction + diabetes mellitus (DM) (95% CI: 0.799–0.962; P = 0,001), and left ventricular ejection fraction + low HDL + DM (95% CI: 0.841–0.98; P = 0,001). Conclusion: The influence of the lower left ventricular ejection fraction to clinical outcome of ischemic stroke patients has a worsening of neurological deficit outcome by considering the combination of several independent variables including the DM and low HDL.
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Rahmayani et al. (2018) conducted a cohort in Acute ischemic stroke (n=62). Left ventricular ejection fraction <48% vs. Left ventricular ejection fraction >48% was evaluated on Clinical deterioration of neurological deficit measured by National Institutes of Health Stroke Scale (NIHSS) score increase of 2 points or more (RR 21.33, 95% CI 4.253-107.021, p=0.001). Left ventricular ejection fraction <48% was associated with a 21-fold increased risk of neurological deterioration (RR 21.33, P=0.001) in patients with acute ischemic stroke.
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