Prognostic factors of cardiovascular death in patients with ischemic stroke in the long-term follow up

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Abstract

In a prospective observational non-interventional study included 148 patients with ischemic stroke at the age of 60 (52; 68) years, with sinus rhythm. At the end of the acute stroke period (21-22 days) was performed Holter monitoring with the assessment of arrhythmias and heart rate variability (HRV). Duration of prospective follow-up was 35 (28; 40) months. We register all cases of cardiovascular death (CD), including death due to recurrent stroke, myocardial infarction (MI), sudden CD (SCD), acute heart failure (AHF), pulmonary embolism. During follow up CD was registered in 15 (10%) patients: in 7 patients - due to recurrent stroke, 2 patients - due to acute MI, in 3 - due to AHF, 3 patients - due to SCD. On multivariate regression analysis in sinus rhythm revealed significant association with the development of CD following factors: age over 67 years, male gender, involvement insula in the area of ischemic damage, supraventricular extrasystoles (more than 54 extrasystoles per day), ventricular arrhythmias, bradyarrhythmias, reduced power range of high-frequency (HF) less than 39 ms2 and low frequency less than 180 ms2 HRV. Separately from the number of these factors with increased risk of fatal complications was significantly associated only two parameters: the involvement insula in the cerebral infarct area (p<0.02) and the power spectrum of the HF<39 ms2 (p<0.04).

About the authors

A. V Fonyakin

Research Center of Neurology

Email: Fonyakin@mail.ru
д-р мед. наук, проф., рук. лаб. кардионеврологии 2-го неврологического отд-ния ФГБНУ НЦН 125367, Russian Federation, Moscow, Volokolamskoe sh., d. 80

L. A Geraskina

Research Center of Neurology

д-р мед. наук, вед. науч. сотр. лаб. кардионеврологии 2-го неврологического отделения ФГБНУ НЦН 125367, Russian Federation, Moscow, Volokolamskoe sh., d. 80

V. A Shandalin

Research Center of Neurology

канд. мед. наук, науч. сотр. лаб. кардионеврологии 2-го неврологического отд-ния ФГБНУ НЦН 125367, Russian Federation, Moscow, Volokolamskoe sh., d. 80

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