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.
Mechanical thrombectomy in patients with heart failure: the Italian registry of endovascular treatment in acute stroke / Gentile, Luana; Pracucci, Giovanni; Saia, Valentina; Falcou, Anne; Biraschi, Francesco; Zini, Andrea; Simonetti, Luigi; Riva, Letizia; Bigliardi, Guido; Vallone, Stefano; Nencini, Patrizia; Limbucci, Nicola; Diomedi, Marina; Da Ros, Valerio; Longoni, Marco; Ruggiero, Maria; Tassinari, Tiziana; Allegretti, Luca; Cerrato, Paolo; Rubino, Elisa; Bergui, Mauro; Cavallo, Roberto; Naldi, Andrea; Comelli, Chiara; Cappellari, Manuel; Zivelonghi, Cecilia; Plebani, Mauro; De Vito, Alessandro; Merli, Nicola; Saletti, Andrea; Fortunata Musolino, Rosa; Ferraù, Ludovica; Lucio Vinci, Sergio; Sacco, Simona; Orlandi, Berardino; DE SANTIS, Federica; Filauri, Pietro; Ruiz, Luigi; Nicoletta Sepe, Federica; Gallesio, Ivan; Petruzzellis, Marco; Chiumarulo, Luigi; Sangalli, Davide; Salmaggi, Andrea; Filizzolo, Marco; Moller, Jessica; Melis, Maurizio; Comelli, Simone; Magoni, Mauro; Gilberti, Nicola; Gasparotti, Roberto; Invernizzi, Paolo; Pavia, Marco; Pinto, Vincenza; Laspada, Salvatore; Marcheselli, Simona; Ajello, Daniele; Viaro, Federica; Baracchini, Claudio; Causin, Francesco; Giannini, Nicola; Chiara Caselli, Maria; Mancuso, Michelangelo; Cosottini, Mirco; Scoditti, Umberto; Menozzi, Roberto; Russo, Monia; Amistá, Pietro; Napoletano, Rosa; Giuseppe Romano, Daniele; Tassi, Rossana; Bracco, Sandra; Carimati, Federico; Versino, Maurizio; Giorgianni, Andrea; De Boni, Antonella; Fasano, Antonio; Barbarini, Leonardo; Paladini, Adriana; Franchini, Enrica; Dall’Ora, Elisa; Comai, Alessio; Giovanni, Frisullo; Pedicelli, Alessandro; Sallustio, Fabrizio; Casetta, Ilaria; Fainardi, Enrico; Mangiafico, Salvatore; Toni, Danilo; Registry of Endovascular Treatment in Acute Stroke (IRETAS) Collaborators, Italian. - In: NEUROLOGICAL SCIENCES. - ISSN 1590-1874. - 44:10(2023), pp. 3577-3585. [10.1007/s10072-023-06830-9]
Mechanical thrombectomy in patients with heart failure: the Italian registry of endovascular treatment in acute stroke
Luana GentilePrimo
;Valentina SaiaSecondo
;Anne Falcou;Francesco Biraschi;Roberto Cavallo;Federica De Santis;Vincenza Pinto;Mirco Cosottini;Rosa Napoletano;Maurizio Versino;Danilo Toni
;
2023
Abstract
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.| File | Dimensione | Formato | |
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