Abstract 1122‐000166: Stroke Severity Factors in patients with Acute Ischemic Stroke and Heart Failure Stratifying by Age

Abstract

Introduction: The goal of this study is to investigate the clinical risk factors associated with acute ischemic stroke (AIS) severity in heart failure (HF) patients above and below 70 years old using the National Institutes of Health Stroke Scale (NIHSS) as a measure for stroke severity. Methods: This study uses retrospective analysis of AIS patients who were previously diagnosed with HF. Data was collected from a regional stroke center from January 2010 to June 2016. Multivariate logistic regression identified the factors associated with stroke severity, with a NIHSS score <7 indicating low severity and a score ≥7 indicating high severity. These results were stratified by patient ages of < and ≥70 years old. Results: A total of 590 patients presented with AIS and a previous diagnosis of HF. The AIS‐HF population contained 223 patients that were <70 years old and 367 that were ≥70 years old. In the AIS‐HF population, patients who were ≥70 years old who presented with coronary artery stenosis (CAS) (OR = 8.592, 95% CI, 2.123‐34.772, P <0.003), prosthetic heart valve (OR = 22.028, 95% CI, 1.454‐333.746, P <0.026), elevated systolic blood pressure (OR = 1.014, 95% CI, 1.002‐1.026, P < 0.024), and tissue plasminogen activator (tPA) administration (OR = 4.002, 95% CI, 1.912‐8.377, P < 0.001) were associated with a higher NIHSS. Alternatively, those that presented with gender differences (OR = 0.466, 95% CI, 0.235‐0.925, P < 0.029), family history of stroke (OR = 0.084, 95% CI, 0.010‐0.726, P < 0.024), obesity (OR = 0.493, 95% CI, 0.261‐0.930, P < 0.029), smoking (OR = 0.253, 95% CI, 0.063‐1.022, P < 0.054), serum creatinine (OR = 0.629, 95% CI, 0.399‐0.992, P < 0.046), INR level (OR = 0.457, 95% CI, 0.191‐1.094, P < 0.079) were associated with a lower NIHSS. Conclusions: The data revealed a variety of components that may affect Stroke Severity in AIS patients with HF. The associated factors exhibited significant differences between distinct age groups. AIS‐HF patients ≥70 years old who presented with CAS, prosthetic heart valve, elevated systolic blood pressure, and received tPA administration were associated with higher stroke severity (≥7 NIHSS) compared to <70 years old group. Identifying more concrete clinical and demographic associations may aid in the identification and evidence‐based management of patients who suffer from AIS.

Keywords

• Stroke
• TPA
• Ischemic Stroke
• Acute Stroke
• Decision Analysis