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Abstract
Objective: To investigate the role of left ventricular wall motion abnormalities (LVWMA), unrelated to high-risk cardioembolic conditions, in stroke recurrence.
Methods: This study included consecutive acute ischemic stroke patients. Transthoracic echocardiography was performed as a routine evaluation for stroke patients. The outcomes were the time to recurrent any stroke and ischemic stroke.
Results: Among 4,316 acute ischemic stroke patients, 430 had LVWMA without high-risk cardioembolic sources. The median observation periods of patients at risk of any stroke and ischemic stroke were 24.5 and 24.7 months. During the follow-up, any stroke and ischemic stroke recurrence were observed in 310 (7.2%) and 250 (5.8%) patients. LVWMA were associated with outcomes after adjustment for traditional cardiovascular risk factors, laboratory and imaging variables, and therapeutic interventions (hazard ratio [HR] 1.707, 95% confidence interval [CI] 1.262–2.310 for any stroke; HR 1.709, 95% CI 1.222–2.390 for ischemic stroke). Moreover, LVWMA could still be considered as independent risk factors after correction for covariates that were significantly associated with outcomes in univariable regression (HR 1.747, 95% CI 1.292–2.364 for any stroke; HR 1.704, 95% CI 1.219–2.382 for ischemic stroke). There were no significant interactions between LVWMA and outcomes between the subgroups except for the statin treatment subgroup.
Conclusions: This study suggests that LVWMA, even when unassociated with high-risk cardioembolic sources, could be an independent predictor for stroke recurrence in patients with ischemic stroke.
GLOSSARY
- CAD=
- coronary artery disease;
- CE=
- cardioembolic;
- CI=
- confidence interval;
- CRP=
- C-reactive protein;
- HR=
- hazard ratio;
- KUSR=
- Korea University Stroke Registry;
- LDL=
- low-density lipoprotein;
- LVWMA=
- left ventricular wall motion abnormalities;
- MI=
- myocardial infarction;
- NIHSS=
- NIH Stroke Scale
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
Editorial, page 510
- Received June 12, 2016.
- Accepted in final form September 30, 2016.
- © 2017 American Academy of Neurology
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