Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Stroke in patients with aortic stenosis: the Simvastatin and Ezetimibe in Aortic Stenosis study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Characteristics and Outcomes in Patients With COVID-19 and Acute Ischemic Stroke: The Global COVID-19 Stroke Registry

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Incidence of Ischemic Stroke in Individuals With and Without Aortic Valve Stenosis: A Danish Retrospective Cohort Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Global Burden of Small Vessel Disease-Related Brain Changes on MRI Predicts Cognitive and Functional Decline

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Switching from Vitamin K Antagonist to Dabigatran in Atrial Fibrillation: Differences According to Dose

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Vitamin K antagonists vs. direct oral anticoagulants after transcatheter aortic valve implantation in atrial fibrillation

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Pulmonary Arterial Enlargement in Well-Treated Persons With Human Immunodeficiency Virus

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Left ventricular myocardial crypts: morphological patterns and prognostic implications

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Left ventricular trabeculation and major adverse cardiovascular events: the Copenhagen General Population Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

BACKGROUND AND PURPOSE: There are limited data on risk stratification of stroke in aortic stenosis. This study examined predictors of stroke in aortic stenosis, the prognostic implications of stroke, and how aortic valve replacement (AVR) with or without concomitant coronary artery bypass grafting influenced the predicted outcomes.

METHODS: Patients with mild-to-moderate aortic stenosis enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Diabetes mellitus, known atherosclerotic disease, and oral anticoagulation were exclusion criteria. Ischemic stroke was the primary end point, and poststroke survival a secondary outcome. Cox models treating AVR as a time-varying covariate were adjusted for atrial fibrillation and congestive heart failure, hypertension, age≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years and female sex (CHA2DS2-VASc) scores.

RESULTS: One thousand five hundred nine patients were followed for 4.3±0.8 years (6529 patient-years). Rates of stroke were 5.6 versus 21.8 per 1000 patient-years pre- and post-AVR; 429 (28%) underwent AVR and 139 (9%) died. Atrial fibrillation (hazard ratio [HR], 2.7; 95% confidence interval [CI], 1.1-6.6), CHA2DS2-VASc score (HR 1.4 per unit; 95% CI, 1.1-1.8), diastolic blood pressure (HR, 1.4 per 10 mm Hg; 95% CI, 1.1-1.8), and AVR with concomitant coronary artery bypass grafting (HR, 3.2; 95% CI, 1.4-7.2, all P≤0.026) were independently associated with stroke. Incident stroke predicted death (HR, 8.1; 95% CI, 4.7-14.0; P<0.001).

CONCLUSIONS: In patients with aortic stenosis not prescribed oral anticoagulation, atrial fibrillation, AVR with concomitant coronary artery bypass grafting, and CHA2DS2-VASc score were the major predictors of stroke. Incident stroke was strongly associated with mortality.

CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00092677.

OriginalsprogEngelsk
TidsskriftStroke; a journal of cerebral circulation
Vol/bind45
Udgave nummer7
Sider (fra-til)1939-46
Antal sider8
ISSN0039-2499
DOI
StatusUdgivet - jul. 2014

ID: 45027582