SynthesisEuropean heart journal2023
Stroke in patients with heart failure and reduced or preserved ejection fraction.
Synthesis in European heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed.
- Machine learning for stroke in heart failure with reduced ejection fraction but without atrial fibrillation: A post-hoc analysis of the WARCEF trial.European journal of clinical investigation · 2025Trial
- Machine learning prediction models for mechanical ventilation requirement in patients with embolic stroke: a retrospective cohort study based on MIMIC-IV.Frontiers in medicine · 2026Article
- Sex differences in risk factors, stroke etiology, treatment characteristics, and outcomes after endovascular treatment for anterior circulation ischemic stroke.Frontiers in stroke · 2026Article
- Beyond cardiac embolism and cryptogenic stroke: unveiling the mechanisms of cerebrovascular events in Chagas disease.Lancet regional health. Americas · 2025Review
- Heart Failure and Stroke: A Narrative Review.Journal of clinical medicine · 2025Review
- The Critical Role of Comorbidities in Managing Heart Failure with Preserved Ejection Fraction (HFpEF).ESC heart failure · 2025Article
- Advances in pathophysiological mechanisms and therapeutic efficacy of exercise rehabilitation in patients with heart failure with preserved ejection fraction.Frontiers in cardiovascular medicine · 2025Review
- Embolic strokes of undetermined source: a clinical consensus statement of the ESC Council on Stroke, the European Association of Cardiovascular Imaging and the European Heart Rhythm Association of the ESC.European heart journal · 2024Article
- Web-Based Dynamic Nomogram for Predicting Risk of Mortality in Heart Failure with Mildly Reduced Ejection Fraction.Risk management and healthcare policy · 2024Article
- Prevalence and incidence of diastolic dysfunction in atrial fibrillation: clinical implications.European heart journal · 2023Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
aimsStroke is an important problem in patients with heart failure (HF), but the intersection between the two conditions is poorly studied across the range of ejection fraction. The prevalence of history of stroke and related outcomes were investigated in patients with HF. METHODS AND
resultsIndividual patient meta-analysis of seven clinical trials enrolling patients with HF with reduced (HFrEF) and preserved ejection fraction (HFpEF). Of the 20 159 patients with HFrEF, 1683 (8.3%) had a history of stroke, and of the 13 252 patients with HFpEF, 1287 (9.7%) had a history of stroke. Regardless of ejection fraction, patients with a history of stroke had more vascular comorbidity and worse HF. Among those with HFrEF, the incidence of the composite of cardiovascular death, HF hospitalization, stroke, or myocardial infarction was 18.23 (16.81-19.77) per 100 person-years in those with prior stroke vs. 13.12 (12.77-13.48) in those without [hazard ratio 1.37 (1.26-1.49), P < 0.001]. The corresponding rates in patients with HFpEF were 14.16 (12.96-15.48) and 9.37 (9.06-9.70) [hazard ratio 1.49 (1.36-1.64), P < 0.001]. Each component of the composite was more frequent in patients with stroke history, and the risk of future stroke was doubled in patients with prior stroke. Among patients with prior stroke, 30% with concomitant atrial fibrillation were not anticoagulated, and 29% with arterial disease were not taking statins; 17% with HFrEF and 38% with HFpEF had uncontrolled systolic blood pressure (≥140 mmHg).
conclusionHeart failure patients with a history of stroke are at high risk of subsequent cardiovascular events, and targeting underutilization of guideline-recommended treatments might be a way to improve outcomes in this high-risk population.
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