Ischemic stroke survivors who have major heart complications within a month of the event face an increased risk of death, heart attack or another stroke within five years, according to new research.
The findings are published today in peer-reviewed journal, Stroke.
Ischemic stroke is the most common type of stroke, accounting for around 85 per cent of strokes in the UK and 87 per cent in the US.
Many people suffer from cardiovascular complications after their stroke, known as stroke-heart syndrome.
Complications can include atrial fibrillation (AF), angina, heart attack and heart failure which can all increase the risk of disability and death in the short term.
Benjamin J.R. Buckley, Ph.D., lead author of the study and a postdoctoral research fellow in preventive cardiology at the Liverpool Centre for Cardiovascular Science, University of Liverpool, said:
“We know heart disease and stroke share similar risk factors, and there’s a two-way relationship between the risk of stroke and heart disease.
“For example, heart conditions such as atrial fibrillation increase the risk of stroke, and stroke also increases the risk of heart conditions.
“We wanted to know how common newly diagnosed heart complications are after a stroke and, importantly, whether stroke-heart syndrome is associated with increased risk of long-term major adverse events.”
Researchers analysed the medical records of 365,000 adults treated for ischemic stroke at more than 50 healthcare sites predominantly in the United States, between 2002 and 2021.
Patients diagnosed with stroke-heart complications within four weeks after their stroke were paired with a control group who did not have complications.
After adjusting for potential confounding factors, such as age, sex and race/ethnicity, the analysis revealed:
- Risk of death within five years after a stroke significantly increased among the participants with new heart complications: 49 per cent more likely if they had developed acute coronary syndrome; 45 per cent more likely if they had developed atrial fibrillation/flutter; and 83 per cent more likely if they developed heart failure
- Chance of hospitalisation and heart attack within five years after a stroke was also significantly higher among those who developed heart complications within the one-month window.
- People who developed atrial fibrillation after stroke were 10 per cent more likely to have a second stroke within five years after their stroke.
- People with stroke and newly diagnosed cardiovascular complications were 50 per cent more likely to have a recurrent stroke within five years after the first stroke.
Buckley said:
“I was particularly surprised by how common stroke-heart syndrome was and the high rate of recurrent stroke in all subgroups of adults with stroke-heart syndrome.
“This means that this is a high-risk population where we should focus more secondary prevention efforts.”
“We also need to develop and implement treatments to improve outcomes for people with stroke-heart syndrome.
“For example, comprehensive exercise-based rehabilitation may be helpful after a stroke, so for people with stroke and newly developed heart complications, it should also be beneficial, maybe even more so. I think this is an interesting area for future research.”
