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Cardiologia Croatica, Vol. 19 No. 11-12, 2024.

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https://doi.org/10.15836/ccar2024.461

Is there an additional risk of ischemic stroke in patients with severe aortic stenosis apart from atrial fibrillation?

Karolina Beg orcid id orcid.org/0009-0009-6670-9956 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Sandra Jakšić Jurinjak orcid id orcid.org/0000-0002-7349-6137 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Andro Koren orcid id orcid.org/0009-0006-7586-1624 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Luciana Koren orcid id orcid.org/0009-0002-1994-3511 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Vice Zubak orcid id orcid.org/0009-0004-0688-7834 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Vlatka Rešković Lukšić orcid id orcid.org/0000-0002-4721-3236 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Marija Brestovac orcid id orcid.org/0000-0001-8446-6120 ; University Hospital Centre Zagreb, Zagreb, Croatia
Martina Lovrić Benčić orcid id orcid.org/0000-0003-1542-2890 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Joško Bulum orcid id orcid.org/0000-0002-1482-6503 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Zvonimir Ostojić orcid id orcid.org/0000-0003-1762-9270 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Blanka Glavaš Konja orcid id orcid.org/0000-0003-1134-4856 ; University Hospital Centre Zagreb, Zagreb, Croatia
Jadranka Šeparović Hanževački orcid id orcid.org/0000-0002-3437-6407 ; University of Zagreb, School of Medicine, Zagreb, Croatia

Puni tekst: engleski pdf 147 Kb

str. 461-461

preuzimanja: 158

citiraj

Preuzmi JATS datoteku

Sažetak

Ključne riječi

aortic valve stenosis; atrial fibrillation; ischemic stroke

Hrčak ID:

328048

URI

https://hrcak.srce.hr/328048

Datum izdavanja:

13.12.2024.

Posjeta: 448 *

Copyright statement: Croatian Cardiac Society

Copyright: 2024, Croatian Cardiac Society

Date received: 13 October 2024

Date: 31 October 2024

Publication date: November 2024

Publication date: November 2024

Volume: 19

Issue: 11-12

Page: 461

Publisher ID: CC 2024 19_11-12_461

DOI: 10.15836/ccar2024.461

Article Information (continued)

Categories:

Subject: Extended Abstract

Categories:

Subject: Valvular heart disease

KEYWORDS: :

KEYWORDS:

Keyword: aortic valve stenosis

Keyword: atrial fibrillation

Keyword: ischemic stroke

Is there an additional risk of ischemic stroke in patients with severe aortic stenosis apart from atrial fibrillation?

[https://orcid.org/0009-0009-6670-9956] Karolina Beg[1][*]

[https://orcid.org/0000-0002-7349-6137] Sandra Jakšić Jurinjak[1][2]

[https://orcid.org/0009-0006-7586-1624] Andro Koren[1]

[https://orcid.org/0009-0002-1994-3511] Luciana Koren[1]

[https://orcid.org/0009-0004-0688-7834] Vice Zubak[1]

[https://orcid.org/0000-0002-4721-3236] Vlatka Rešković Lukšić[1][2]

[https://orcid.org/0000-0001-8446-6120] Marija Brestovac[2]

[https://orcid.org/0000-0003-1542-2890] Martina Lovrić Benčić[1][2]

[https://orcid.org/0000-0002-1482-6503] Joško Bulum[1][2]

[https://orcid.org/0000-0003-1762-9270] Zvonimir Ostojić[1][2]

[https://orcid.org/0000-0003-1134-4856] Blanka Glavaš Konja[2]

[https://orcid.org/0000-0002-3437-6407] Jadranka Šeparović Hanževački[1][2]

 

[1] University of Zagreb, School of Medicine, Zagreb, Croatia

[2] University Hospital Centre Zagreb, Zagreb, Croatia

Author notes:

Correspondence to: [*] ADDRESS FOR CORRESPONDENCE: Karolina Beg, Medicinski fakultet, Šalata 3, HR-10000 Zagreb, Croatia. / Phone: +385-91-437-4456 / E-mail: sjaksicj@gmail.com

Introduction: Severe aortic stenosis (AS) is associated with an increased risk of developing ischemic stroke, but there is a lack of data on the impact of atrial fibrillation (AF). (1-3) Therefore, our aim was to identify variables related to cerebrovascular insult (CVI) in calcified severe AS, apart from AF.

Patients and Methods: We retrospectively analyzed a database of 353 patients with severe aortic stenosis who were admitted from September 2020 to July 2023 at the Heart Valve Department of the University Hospital Centre Zagreb. Patients had an average age of 78.7 years ± 8.6 (range: 42-95), with 53.3% being female, and an average BMI of 27.7 ± 5.08 (range: 15.6-44.4). They were divided into four groups: (Group I) those with AF and CVI, (Group II) those in sinus rhythm (SR) and CVI, (Group III) those with AF and no-CVI, (Group IV) those in sinus rhythm SR and no-CVI. For the group of patients with AF, we calculated the CHA2DS2-VASc score.

Results: Of the 353 analyzed patients with severe aortic stenosis, 138 (39.1%) had AF with an average CHA2DS2-VASc score of 4.841 (±1.395). Marked at the time of inclusion patients with AF had anticoagulation therapy. Additionally, the average CHA2DS2-VASc score in the group of patients with AF and no-CVI was 4.549 (±1.165) and in the group of patients with AF and CVI was 7.063 (±0.929), as expected. When analyzed the group of patients with AF and history of CVI and severe AS (11.6%), there was a significant difference (p 0.008), as in the SR group and CVI, there were 9.3% of patients with a history of CVI (p 0.006). No difference was found comparing a pair of patient groups (SR and AF) with CVI (p 0.490), suggesting an increased risk of stroke in the presence of calcified aortic valve stenosis could be an independent risk factor. Considering other risk factors, in the group with AF and CVI, 93.8% had hypertension, 56.3% had diabetes mellitus (DM), and 25% of patients were smokers. Only DM, as a risk factor, showed a tendency for positive significance between the groups AF and SR (respectively p 0.065, p 0.074).

Conclusion: In our group of patients with severe calcified aortic stenosis, there is a significant risk of ischemic stroke, apart from atrial fibrillation at the time of diagnosis, suggesting an increased risk of stroke in the presence of calcified aortic valve stenosis that could be an independent risk factor.

LITERATURE

1 

Greve AM, Dalsgaard M, Bang CN, Egstrup K, Ray S, Boman K, et al. Stroke in patients with aortic stenosis: the Simvastatin and Ezetimibe in Aortic Stenosis study. Stroke. 2014 July;45(7):1939–46. https://doi.org/10.1161/STROKEAHA.114.005296 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/24903982

2 

Andreasen C, Gislason GH, Køber L, Abdulla J, Martinsson A, Smith JG, et al. Incidence of Ischemic Stroke in Individuals With and Without Aortic Valve Stenosis: A Danish Retrospective Cohort Study. Stroke. 2020 May;51(5):1364–71. https://doi.org/10.1161/STROKEAHA.119.028389 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/32216533

3 

Ito A, Iwata S, Tamura S, Kim AT, Nonin S, Ishikawa S, et al. Prevalence and Risk Factors of Silent Brain Infarction in Patients with Aortic Stenosis. Cerebrovasc Dis Extra. 2020;10(3):116–23. https://doi.org/10.1159/000510438 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/33032286

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