Major heart complications soon after a stroke can put survivors at higher risk for a heart attack, death or another stroke within five years, new research shows.
Heart problems after a stroke are common and are referred to as stroke-heart syndrome. These heart problems were known to increase stroke survivors’ short-term risk of disability and death, but the long-term impacts had been unclear.
“I was particularly surprised by how common stroke-heart syndrome was and the high rate of recurrent stroke in all subgroups of adults with stroke-heart syndrome,” said study lead author Benjamin Buckley, a postdoctoral research fellow at the University of Liverpool in England. “This means that this is a high-risk population where we should focus more secondary prevention efforts.”
He and his colleagues analyzed the medical records of more than 365,000 adult survivors of ischemic stroke treated at more than 50 health care sites — most of them in the United States — between 2002 and 2021. Ischemic strokes are caused by blocked blood flow in the brain.
The study compared patients diagnosed with stroke-heart complications within four weeks of a stroke and an equal number of stroke survivors without heart complications (control group).
About 1 in 10 stroke survivors (11.1%) developed acute coronary syndrome; 8.8% developed the heart rhythm disorder atrial fibrillation (a-fib), and 6.4% developed heart failure. In all, 1.2% had severe rhythm disorders called ventricular arrhythmias and 0.1% developed so-called “broken heart” (Takotsubo) syndrome, the study found.
Compared to those in the control group, the risk of death within five years was significantly higher among those diagnosed with new heart complications within four weeks of their stroke.
The risk of death was 49% higher if they had acute coronary syndrome; 45% higher if they had a-fib/flutter; 83% higher if they had heart failure, and twice as high if they had severe ventricular arrhythmias.
The risk of hospitalization and heart attack within five years was also significantly higher among those who developed heart problems within four weeks of their stroke, according to findings published March 31 in the journal Stroke.
It also found within five years after their stroke, stroke survivors with Takotsubo syndrome were 89% more likely to have a major heart event; those with a-fib were 10% more likely to have a second stroke, and those with newly diagnosed heart complications were 50% more likely to have a recurrent stroke.
Buckley said the study shows the need for treatments to improve outcomes for people with stroke-heart syndrome.
“For example, comprehensive exercise-based rehabilitation may be helpful after a stroke, so for people with stroke and newly developed heart complications, it should also be beneficial, maybe even more so,” he said in a journal news release. “I think this is an interesting area for future research.”
The American Stroke Association offers resources for stroke survivors.
SOURCE: Stroke, news release, March 31, 2022
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