Hoad, K, Buckley, B, Helen, J, Miller, G, Lip, G and Abdul-Rahim, A Stroke-Heart Syndrome: Incidence and Clinical Outcomes of Cardiac Complications Following Intracerebral Haemorrhage. European Stroke Journal. ISSN 2396-9873 (Accepted)

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Abstract

Introduction: Newly diagnosed cardiovascular complications following an ischaemic stroke, termed stroke-heart syndrome, are common and associated with worse outcomes. Little is known regarding stroke-heart syndrome in relation to intracerebral haemorrhage (ICH). This study aimed to investigate the incidence and 5-year major adverse cardiovascular events (MACE; acute myocardial infarction, ischaemic stroke, all-cause mortality and recurrent ICH) of newly diagnosed cardiovascular complications following incident ICH, using a global federated database. Methods: A retrospective cohort study was conducted using anonymised electronic medical records. Patients aged ≥18 years with non-traumatic ICH and 5-year follow-up were included. Patients with newly diagnosed cardiovascular complications within 4 weeks following the initial ICH were 1:1 propensity score-matched with patients without new-onset cardiovascular complications. Each cardiovascular complications were investigated as a composite stroke-heart syndrome cohort and separately for associated MACE. Cox hazard regression models were used to determine the 5-year incidence of MACE. Results: Before propensity score matching, 171,489 patients with nontraumatic ICH, 15% experienced ≥1 newly diagnosed cardiovascular complication within 4 weeks. After matching, patients with ICH and cardiovascular complications were associated with a significantly higher risk of 5-year MACE (HR 1.35 [95% CI 1.32-1.38]), and in each composite compared to matched controls. There was no significant risk of rehospitalisation over 5-year follow-up [HR 0.90 [0.73-1.13]). The risk of MACE was significantly higher in patients with newly diagnosed cardiovascular complications (separately). Conclusions: Newly diagnosed cardiovascular complications following ICH (i.e., stroke-heart syndrome) were common and associated with a significantly worsened 5-year prognosis.

Item Type:	Article
Additional Information:	This is the Accepted Version accepted for publication in Journal Title European Stroke Journal.
Uncontrolled Keywords:	stroke-heart syndrome; intracerebral haemorrhage; arrhythmias; heart failure; outcomes
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport & Exercise Sciences
Publisher:	SAGE Publications
SWORD Depositor:	A Symplectic
Date Deposited:	25 Jun 2024 14:58
Last Modified:	25 Jun 2024 14:58
URI:	https://researchonline.ljmu.ac.uk/id/eprint/23480

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