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Risk of stroke in c...
Risk of stroke in chronic heart failure patients with preserved ejection fraction, but without atrial fibrillation: analysis of the CHARM-Preserved and I-Preserve trials
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Abdul-Rahim, A. H. (author)
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Perez, A. C. (author)
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MacIsaac, R. L. (author)
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Jhund, P. S. (author)
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Claggett, B. L. (author)
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Carson, P. E. (author)
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Komajda, M. (author)
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McKelvie, R. S. (author)
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Zile, M. R. (author)
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- Swedberg, Karl, 1944 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Yusuf, S. (author)
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Pfeffer, M. A. (author)
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Solomon, S. D. (author)
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Lip, G. Y. H. (author)
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Lees, K. R. (author)
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McMurray, J. J. V. (author)
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Candesartan Heart Failure Assessme; Irbesartan Heart Failure, Preserved (author)
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(creator_code:org_t)
- 2016-11-13
- 2017
- English.
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In: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 38:10, s. 742-750
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https://academic.oup...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- Aims The incidence and predictors of stroke in patients with heart failure and preserved ejection fraction (HF-PEF), but without atrial fibrillation (AF), are unknown. We described the incidence of stroke in HF-PEF patients with and without AF and predictors of stroke in those without AF. Methods and results We pooled data from the CHARM-Preserved and I-Preserve trials. Using Cox regression, we derived a model for stroke in patients without AF in this cohort and compared its performance with a published model in heart failure patients with reduced ejection fraction (HF-REF)-predictive variables: age, body mass index, New York Heart Association class, history of stroke, and insulin-treated diabetes. The two stroke models were compared and Kaplan-Meier curves for stroke estimated. The risk model was validated in a third HF-PEF trial. Of the 6701 patients, 4676 did not have AF. Stroke occurred in 124 (6.1%) with AF and in 171 (3.7%) without AF (rates 1.80 and 1.00 per 100 patient-years, respectively). There was no difference in performance of the stroke model derived in the HF-PEF cohort and the published HF-REF model (c-index 0.71, 95% confidence interval 0.57-0.84 vs. 0.73, 0.59-0.85, respectively) as the predictive variables overlapped. The model performed well in the validation cohort (0.86, 0.62-0.99). The rate of stroke in patients in the upper third of risk approximated to that in patients with AF (1.60 and 1.80 per 100 patient-years, respectively). Conclusions A small number of clinical variables identify a subset of patients with HF-PEF, but without AF, at elevated risk of stroke.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Heart failure with preserved ejection fraction
- Stroke
- Risk-factors
- left-ventricular dysfunction
- randomized-trial
- controlled rosuvastatin
- multinational trial
- systolic function
- sinus rhythm
- warfarin
- epidemiology
- hypertension
- outcomes
- Cardiovascular System & Cardiology
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Abdul-Rahim, A. ...
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Perez, A. C.
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MacIsaac, R. L.
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Jhund, P. S.
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Claggett, B. L.
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Carson, P. E.
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show more...
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Komajda, M.
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McKelvie, R. S.
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Zile, M. R.
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Swedberg, Karl, ...
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Yusuf, S.
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Pfeffer, M. A.
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Solomon, S. D.
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Lip, G. Y. H.
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Lees, K. R.
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McMurray, J. J. ...
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Candesartan Hear ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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European Heart J ...
- By the university
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University of Gothenburg