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Factors Identify Stroke Patients at Risk of Cardiac Events

Some patients at high risk may need more aggressive treatment

THURSDAY, Aug. 23 (HealthDay News) -- Stroke patients with heart failure, diabetes and other factors are at risk of having a serious cardiac event shortly after the stroke and may benefit from more aggressive treatment, according to study findings published in the August issue of Stroke.

Stephen Davis, M.D., of the Royal Melbourne Hospital in Victoria, Australia, and colleagues analyzed data on 846 ischemic stroke patients, including 35 (4.1 percent) who died of cardiac causes and 161 (19 percent) who had at least one serious cardiac adverse event within three months of the stroke.

Five factors elevated the risk of cardiac events, including a history of heart failure, which was associated with a threefold higher risk, and diabetes, which more than doubled the risk. Baseline creatinine of more than 115μmol/L increased the odds about 1.7-fold. Those who had a severe stroke (odds ratio, 1.98) or long QTc or ventricular extrasystoles on ECG (OR, 1.93) also were at risk.

The risk of serious cardiac events ranged from 6.3 percent for patients with no predictors to 62.2 percent for those with four or more predictors. The risk of cardiac death ranged from zero for those with no risk factors to 18.9 percent for those with four or more predictors.

"We argue that very high-risk patients should be monitored for at least 72 hours, and that the capability to provide continuous physiological monitoring should be offered in all stroke units," the authors conclude.

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