Age Stratification in Acute Ischemic Stroke Patients with Heart Failure
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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65 to 74 Years Old | Greater Than ≥75 Years Old | |||||
---|---|---|---|---|---|---|
Characteristic | NIHSS ≤ 7 | NIHSS > 7 | NIHSS ≤ 7 | NIHSS > 7 | ||
Number of patients | 61 | 52 | p-value | 105 | 149 | p-value |
Age Group: No. (%) | ||||||
<50 years | 0 | 0 | 0.748 | 0 | 0 | 0.037 * a |
50–59 | 0 | 0 | 0 | 0 | ||
60–69 | 30 (49.2) | 24 (46.2) | 0 | 0 | ||
70–79 | 31 (50.8) | 28 (53.8) | 34 (32.4) | 31 (20.8) | ||
>=80 | 0 | 0 | 71 (67.6) | 118 (79.2) | ||
Age Mean ± SD | 69.98 ± 3.16 | 70.02 ± 3.32 | 0.954 | 82.98 ± 4.96 | 84.58 ± 5.45 | 0.018 * b |
Race: No (%) | ||||||
White | 45 (73.8) | 41 (78.8) | 0.790 | 91 (86.7) | 127 (85.2) | 0.342 |
Black | 14 (23.0) | 10 (19.2) | 14 (13.3) | 19 (12.8) | ||
Other | 2 (3.3) | 1 (1.9) | 0 | 3 (2.0) | ||
BMI: Mean ± SD | 30.89 ± 8.15 | 30.44 ± 9.41 | 0.787 | 26.85 ± 6.00 | 25.92 ± 6.01 | 0.232 |
Gender (%) | ||||||
Female | 34 (55.7) | 65 (61.9) | 0.435 | 24 (46.2) | 107 (71.8) | <0.001 * a |
Male | 27 (44.3) | 40 (38.1) | 28 (53.8) | 42 (28.2) | ||
Medical History: No. (%) | ||||||
Atrial Fib | 26 (42.6) | 22 (42.3) | 0.973 | 57 (54.3) | 93 (62.4) | 0.194 |
Coronary Artery Disease | 44 (72.1) | 28 (53.8) | 0.044 * a | 56 (53.3) | 81 (54.4) | 0.871 |
Carotid Artery Stenosis | 5 (8.2) | 5 (9.6) | 0.791 | 5 (4.8) | 18 (12.1) | 0.045 * a |
Depression | 11 (18.0) | 11 (21.2) | 0.676 | 19 (18.1) | 24 (16.1) | 0.677 |
Diabetes | 32 (52.5) | 26 (50.0) | 0.794 | 41 (39.0) | 64 (43.0) | 0.534 |
Drugs or Alcohol | 1 (1.6) | 2 (3.8) | 0.467 | 1 (1.0) | 1 (0.7) | 0.803 |
Dyslipidemia | 42 (68.9) | 35 (67.3) | 0.861 | 57 (54.3) | 87 (58.4) | 0.516 |
Stroke Family History | 7 (11.5) | 2 (3.8) | 0.135 | 7 (6.7) | 3 (2.0) | 0.060 |
Heart Failure | 61 (100) | 52 (100) | 105 (100) | 149 (100) | ||
Sleep apnea | 1 (1.6) | 4 (7.7) | 0.119 | 5 (4.8) | 5 (3.4) | 0.570 |
Hypertension | 53 (86.9) | 48 (92.3) | 0.351 | 96 (91.4) | 126 (84.6) | 0.104 |
Migraine | 1 (1.6) | 0 (0) | 0.354 | 1 (1.0) | 0 (0) | 0.233 |
Obesity | 28 (45.9) | 21 (40.4) | 0.555 | 41 (39.0) | 44 (29.5) | 0.113 |
Previous Stroke | 20 (32.8) | 22 (42.3) | 0.297 | 35 (33.3) | 43 (28.9) | 0.447 |
Previous TIA (>24 h) | 6 (9.8) | 5 (9.6) | 0.969 | 9 (8.6) | 13 (8.7) | 0.966 |
Prosthetic Heart Valve | 1 (1.6) | 2 (3.8) | 0.467 | 1 (1.0) | 4 (2.7) | 0.328 |
Peripheral Vascular Disease | 3 (4.9) | 12 (23.1) | 0.005 * a | 8 (7.6) | 14 (9.4) | 0.620 |
Chronic Renal Disease | 10 (16.4) | 6 (11.5) | 0.461 | 22 (21.0) | 23 (15.4) | 0.257 |
Smoker | 11 (18.0) | 13 (25.0) | 0.367 | 7 (6.7) | 3 (2.0) | 0.060 |
Medication History: No (%) | ||||||
HTN medication | 50 (82.0) | 46 (88.5) | 0.336 | 98 (93.3) | 135 (90.6) | 0.437 |
Cholesterol Reducer | 40 (65.6) | 32 (61.5) | 0.657 | 62 (59.0) | 81 (54.4) | 0.459 |
Diabetic Medication | 25 (41.0) | 23 (44.2) | 0.728 | 33 (31.4) | 37 (24.8) | 0.247 |
Antidepressant | 10 (16.4) | 10 (19.2) | 0.694 | 17 (16.2) | 22 (14.8) | 0.756 |
Lab values: Mean ± SD | ||||||
Total cholesterol | 159.92 ± 43.21 | 164.49 ± 41.78 | 0.595 | 150.56 ± 45.16 | 156.35 ± 46.05 | 0.355 |
Triglycerides | 149.98 ± 188.98 | 178.04 ± 189.47 | 0.463 | 119.70 ± 73.82 | 102 ± 46.12 | 0.050 * b |
HDL | 41.60 ± 14.57 | 40.60 ± 14.88 | 0.736 | 41.37 ± 12.66 | 43.22 ± 13.11 | 0.299 |
LDL | 94.52 ± 34.08 | 100.74 ± 35.21 | 0.374 | 86.84 ± 36.23 | 93.73 ± 38.42 | 0.180 |
Lipids | 6.60 ± 1.69 | 6.66 ± 1.94 | 0.857 | 6.25 ± 1.35 | 6.20 ± 1.31 | 0.771 |
Blood Glucose | 138.75 ± 64.03 | 153.73 ± 73.65 | 0.268 | 138.09 ± 57.06 | 143.19 ± 59.80 | 0.497 |
Serum Creatinine | 1.52 ± 1.26 | 1.24 ± 0.61 | 0.154 | 1.35 ± 0.56 | 1.29 ± 0.59 | 0.477 |
INR | 1.31 ± 0.53 | 1.19 ± 0.27 | 0.177 | 1.33 ± 0.58 | 1.24 ± 0.38 | 0.194 |
Vital Signs: Mean ± SD | ||||||
Heart Rate | 83.3 ± 16.75 | 87.6 ± 22.67 | 0.267 | 76.9 ± 16.45 | 80.6 ± 16.97 | 0.084 |
Blood Pressure Systolic | 142.21 ± 24.86 | 153.02 ± 30.87 | 0.042 * b | 147.98 ± 24.26 | 156.56 ± 28.59 | 0.010 * b |
Blood Pressure Diastolic | 81.15 ± 16.48 | 83.90 ± 26.63 | 0.537 | 74.60 ± 15.15 | 79.92 ± 22.01 | 0.023 * b |
Ambulation Status Prior to Event: No. (%) | ||||||
Ambulate Independently | 53 (86.9) | 42 (80.8) | 0.436 | 84 (80.0) | 100 (67.1) | 0.178 |
Ambulate with Assistance | 3 (4.9) | 1 (1.9) | 10 (9.5) | 17 (11.4) | ||
Unable to Ambulate | 4 (6.6) | 7 (13.3) | 5 (4.8) | 14 (9.4) | ||
Not Documented | 1 (1.6) | 2 (3.8) | 6 (5.7) | 17 (11.4) | ||
Ambulation Status on Admission: No. (%) | ||||||
Ambulate Independently | 19 (31.1) | 1 (1.9) | <0.001 * a | 18 (17.1) | 0 (0) | <0.001 * a |
Ambulate with Assistance | 26 (42.6) | 7 (13.5) | 49 (46.7) | 15 (10.1) | ||
Unable to Ambulate | 8 (13.1) | 37 (71.2) | 17 (16.2) | 114 (76.5) | ||
Not Documented | 8 (13.1) | 7 (13.5) | 21 (20.0) | 20 (13.4) | ||
Ambulation Status on Discharge: No. (%) | ||||||
Ambulate Independently | 32 (52.5) | 7 (13.5) | <0.001 * a | 30 (28.6) | 5 (3.4) | <0.001 * a |
Ambulate with Assistance | 24 (39.3) | 6 (11.5) | 55 (52.4) | 44 (29.5) | ||
Unable to Ambulate | 4 (6.6) | 30 (57.7) | 17 (16.2) | 75 (50.3) | ||
Not Documented | 1 (1.6) | 9 (17.3) | 3 (2.9) | 25 (16.8) | ||
rtPA Administration | 9 (14.8) | 19 (36.5) | 0.008 * a | 15 (14.3) | 41 (27.5) | 0.012 * a |
Emergency Department | 54 (88.5) | 43 (82.7) | 0.375 | 89 (84.8) | 134 (89.9) | 0.215 |
Direct Admission | 7 (11.5) | 9 (17.3) | 16 (15.2) | 15 (10.1) | ||
Improved Ambulation: No. (%) | 19 (31.7) | 12 (27.9) | 0.682 | 33 (32.0) | 46 (36.8) | 0.452 |
95% C.I. | ||||||
---|---|---|---|---|---|---|
Variables | B Value | Wald | Odds Ratio | Lower | Upper | p-Value |
Drug and alcohol use | 1.004 | 3.575 | 2.73 | 0.964 | 7.731 | 0.059 |
Peripheral Vascular Disease | 1.124 | 8.404 | 3.079 | 1.439 | 6.585 | 0.004 * |
Smoking | −0.867 | 8.787 | 0.420 | 0.237 | 0.745 | 0.003 * |
Serum Creatinine | −0.398 | 7.134 | 0.672 | 0.502 | 0.900 | 0.008 * |
Heart Rate | 0.022 | 10.746 | 1.022 | 1.009 | 1.035 | 0.001 * |
Systolic Blood Pressure | 0.013 | 11.576 | 1.014 | 1.006 | 1.021 | <0.001 * |
Body Mass Index | −0.032 | 4.866 | 0.969 | 0.942 | 0.996 | 0.027 * |
Direct Admission | −0.516 | 2.757 | 0.597 | 0.325 | 1.098 | 0.097 |
95% C.I. | ||||||
---|---|---|---|---|---|---|
Variables | B Value | Wald | Odds Ratio | Lower | Upper | p-Value |
Gender | −0.599 | 2.829 | 0.549 | 0.273 | 1.104 | 0.093 |
Coronary Artery Stenosis | 1.202 | 2.753 | 3.328 | 0.804 | 13.767 | 0.097 |
Smoking | −2.257 | 6.257 | 0.105 | 0.018 | 0.614 | 0.012 * |
Triglycerides | −0.007 | 5.548 | 0.993 | 0.987 | 0.999 | 0.019 * |
INR | −0.790 | 3.408 | 0.454 | 0.196 | 1.050 | 0.045 * |
Heart Rate | 0.031 | 7.204 | 1.032 | 1.009 | 1.057 | 0.007 * |
Direct admission | −1.035 | 4.542 | 0.355 | 0.137 | 0.920 | 0.033 * |
95% C.I. | ||||||
---|---|---|---|---|---|---|
Variables | B Value | Wald | Odds Ratio | Lower | Upper | p-Value |
Previous Stroke | 1.223 | 5.065 | 2.297 | 1.171 | 9.852 | 0.024 * |
Peripheral Vascular Disease | 1.915 | 2.547 | 6.784 | 1.242 | 37.065 | 0.027 * |
Heart Rate | 0.034 | 6.346 | 1.035 | 1.008 | 1.063 | 0.012 * |
Systolic Blood Pressure | 0.023 | 6.382 | 1.023 | 1.005 | 1.041 | 0.012 * |
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Edrissi, C.; Rathfoot, C.; Knisely, K.; Sanders, C.B.; Goodwin, R.; Nathaniel, S.I.; Nathaniel, T. Age Stratification in Acute Ischemic Stroke Patients with Heart Failure. J. Clin. Med. 2023, 12, 38. https://doi.org/10.3390/jcm12010038
Edrissi C, Rathfoot C, Knisely K, Sanders CB, Goodwin R, Nathaniel SI, Nathaniel T. Age Stratification in Acute Ischemic Stroke Patients with Heart Failure. Journal of Clinical Medicine. 2023; 12(1):38. https://doi.org/10.3390/jcm12010038
Chicago/Turabian StyleEdrissi, Camron, Chase Rathfoot, Krista Knisely, Carolyn Breauna Sanders, Richard Goodwin, Samuel I. Nathaniel, and Thomas Nathaniel. 2023. "Age Stratification in Acute Ischemic Stroke Patients with Heart Failure" Journal of Clinical Medicine 12, no. 1: 38. https://doi.org/10.3390/jcm12010038
APA StyleEdrissi, C., Rathfoot, C., Knisely, K., Sanders, C. B., Goodwin, R., Nathaniel, S. I., & Nathaniel, T. (2023). Age Stratification in Acute Ischemic Stroke Patients with Heart Failure. Journal of Clinical Medicine, 12(1), 38. https://doi.org/10.3390/jcm12010038