Details der Publikation - Mechanical thrombectomy in patients with heart failure

Mechanical thrombectomy in patients with heart failure : the Italian registry of Endovascular Treatment in Acute Stroke

© 2023. Fondazione Società Italiana di Neurologia..

BACKGROUND: Heart failure (HF) is the second most important cardiac risk factor for stroke after atrial fibrillation (AF). Few data are available on mechanical thrombectomy (MT) in acute ischemic stroke (AIS) patients with HF.

METHODS: The source of data is the multicentre Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS). All AIS patients ≥ 18 years receiving MT were categorised in two groups: HF and no-HF. Baseline clinical and neuroradiological findings on admission were analysed.

RESULTS: Of 8924 patients, 642 (7.2%) had HF. Compared to the no-HF group, HF patients had higher prevalence of cardiovascular risk factors. Rate of complete recanalisation (TICI 2b-3) was 76.9% in HF vs 78.1% in no-HF group (p = 0.481). Rate of symptomatic intracerebral haemorrhage at 24-h non-contrast computed tomography (NCCT) was 7.6% in HF vs 8.3% in no-HF patients (p = 0.520). At 3 months, 36.4% of HF patients and 48.2% of no-HF patients (p < 0.001) had mRS 0-2, and mortality was, respectively, 30.7% and 18.5% (p < 0.001). In multivariate logistic regression, HF was independently associated with mortality at 3 months (OR 1.53, 1.24-1.88 95% CI, p < 0.001). In multivariate ordinal regression, HF patients had a probability of transitioning to a higher mRS level of 1.23 (1.05-1.44 95% CI, p = 0.012). The propensity score analysis of two groups matched for age, sex, and NIHSS at admission yielded the same results.

CONCLUSION: MT is safe and effective in HF patients with AIS. Patients with HF and AIS suffered from higher 3-month mortality and unfavourable outcome regardless of acute treatments.

Medienart:	E-Artikel

Erscheinungsjahr:	2023
Erschienen:	2023

Enthalten in:	Zur Gesamtaufnahme - volume:44
Enthalten in:	Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology - 44(2023), 10 vom: 18. Okt., Seite 3577-3585

Sprache:	Englisch

Beteiligte Personen:	Gentile, Luana [VerfasserIn] Pracucci, Giovanni [VerfasserIn] Saia, Valentina [VerfasserIn] Falcou, Anne [VerfasserIn] Biraschi, Francesco [VerfasserIn] Zini, Andrea [VerfasserIn] Simonetti, Luigi [VerfasserIn] Riva, Letizia [VerfasserIn] Bigliardi, Guido [VerfasserIn] Vallone, Stefano [VerfasserIn] Nencini, Patrizia [VerfasserIn] Limbucci, Nicola [VerfasserIn] Diomedi, Marina [VerfasserIn] Da Ros, Valerio [VerfasserIn] Longoni, Marco [VerfasserIn] Ruggiero, Maria [VerfasserIn] Tassinari, Tiziana [VerfasserIn] Allegretti, Luca [VerfasserIn] Cerrato, Paolo [VerfasserIn] Rubino, Elisa [VerfasserIn] Bergui, Mauro [VerfasserIn] Cavallo, Roberto [VerfasserIn] Naldi, Andrea [VerfasserIn] Comelli, Chiara [VerfasserIn] Cappellari, Manuel [VerfasserIn] Zivelonghi, Cecilia [VerfasserIn] Plebani, Mauro [VerfasserIn] De Vito, Alessandro [VerfasserIn] Merli, Nicola [VerfasserIn] Saletti, Andrea [VerfasserIn] Musolino, Rosa Fortunata [VerfasserIn] Ferraù, Ludovica [VerfasserIn] Vinci, Sergio Lucio [VerfasserIn] Sacco, Simona [VerfasserIn] Orlandi, Berardino [VerfasserIn] De Santis, Federica [VerfasserIn] Filauri, Pietro [VerfasserIn] Ruiz, Luigi [VerfasserIn] Sepe, Federica Nicoletta [VerfasserIn] Gallesio, Ivan [VerfasserIn] Petruzzellis, Marco [VerfasserIn] Chiumarulo, Luigi [VerfasserIn] Sangalli, Davide [VerfasserIn] Salmaggi, Andrea [VerfasserIn] Filizzolo, Marco [VerfasserIn] Moller, Jessica [VerfasserIn] Melis, Maurizio [VerfasserIn] Comelli, Simone [VerfasserIn] Magoni, Mauro [VerfasserIn] Gilberti, Nicola [VerfasserIn] Gasparotti, Roberto [VerfasserIn] Invernizzi, Paolo [VerfasserIn] Pavia, Marco [VerfasserIn] Pinto, Vincenza [VerfasserIn] Laspada, Salvatore [VerfasserIn] Marcheselli, Simona [VerfasserIn] Ajello, Daniele [VerfasserIn] Viaro, Federica [VerfasserIn] Baracchini, Claudio [VerfasserIn] Causin, Francesco [VerfasserIn] Giannini, Nicola [VerfasserIn] Caselli, Maria Chiara [VerfasserIn] Mancuso, Michelangelo [VerfasserIn] Cosottini, Mirco [VerfasserIn] Scoditti, Umberto [VerfasserIn] Menozzi, Roberto [VerfasserIn] Russo, Monia [VerfasserIn] Amistá, Pietro [VerfasserIn] Napoletano, Rosa [VerfasserIn] Romano, Daniele Giuseppe [VerfasserIn] Tassi, Rossana [VerfasserIn] Bracco, Sandra [VerfasserIn] Carimati, Federico [VerfasserIn] Versino, Maurizio [VerfasserIn] Giorgianni, Andrea [VerfasserIn] De Boni, Antonella [VerfasserIn] Fasano, Antonio [VerfasserIn] Barbarini, Leonardo [VerfasserIn] Paladini, Adriana [VerfasserIn] Franchini, Enrica [VerfasserIn] Dall'Ora, Elisa [VerfasserIn] Comai, Alessio [VerfasserIn] Giovanni, Frisullo [VerfasserIn] Pedicelli, Alessandro [VerfasserIn] Sallustio, Fabrizio [VerfasserIn] Casetta, Ilaria [VerfasserIn] Fainardi, Enrico [VerfasserIn] Mangiafico, Salvatore [VerfasserIn] Toni, Danilo [VerfasserIn] Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) Collaborators [VerfasserIn]

Links:	Volltext

Themen:	Acute ischemic stroke Heart failure Journal Article Left ventricular ejection fraction Mechanical thrombectomy

Anmerkungen:	Date Completed 12.09.2023 Date Revised 22.09.2023 published: Print-Electronic Citation Status MEDLINE

doi:	10.1007/s10072-023-06830-9

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	NLM35702429X

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520			\|a BACKGROUND: Heart failure (HF) is the second most important cardiac risk factor for stroke after atrial fibrillation (AF). Few data are available on mechanical thrombectomy (MT) in acute ischemic stroke (AIS) patients with HF
520			\|a METHODS: The source of data is the multicentre Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS). All AIS patients ≥ 18 years receiving MT were categorised in two groups: HF and no-HF. Baseline clinical and neuroradiological findings on admission were analysed
520			\|a RESULTS: Of 8924 patients, 642 (7.2%) had HF. Compared to the no-HF group, HF patients had higher prevalence of cardiovascular risk factors. Rate of complete recanalisation (TICI 2b-3) was 76.9% in HF vs 78.1% in no-HF group (p = 0.481). Rate of symptomatic intracerebral haemorrhage at 24-h non-contrast computed tomography (NCCT) was 7.6% in HF vs 8.3% in no-HF patients (p = 0.520). At 3 months, 36.4% of HF patients and 48.2% of no-HF patients (p < 0.001) had mRS 0-2, and mortality was, respectively, 30.7% and 18.5% (p < 0.001). In multivariate logistic regression, HF was independently associated with mortality at 3 months (OR 1.53, 1.24-1.88 95% CI, p < 0.001). In multivariate ordinal regression, HF patients had a probability of transitioning to a higher mRS level of 1.23 (1.05-1.44 95% CI, p = 0.012). The propensity score analysis of two groups matched for age, sex, and NIHSS at admission yielded the same results
520			\|a CONCLUSION: MT is safe and effective in HF patients with AIS. Patients with HF and AIS suffered from higher 3-month mortality and unfavourable outcome regardless of acute treatments
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650		4	\|a Acute ischemic stroke
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Mechanical thrombectomy in patients with heart failure : the Italian registry of Endovascular Treatment in Acute Stroke

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