Abstract Details

Title Low Left Ventricular Ejection Fraction in Patients with Acute Ischemic Stroke May Be Predictive of Poor Functional Outcome

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P03 - (-)

Poster/Presentation
Number 199

Objective

Background BACKGROUND: A low LVEF may exacerbate already underperfused cerebral vessels during AIS and therefore result in poor outcome after AIS.

Design/Methods DESIGN/METHODS: Consecutive patients with AIS were retrospectively identified from a prospective registry at a single center between 07/08-12/10. Only patients with known LVEF were included and grouped according to LVEF ("severely low" <30%, "moderately low" 30-49%, and "normal" >50%). Baseline demographics, inpatient complications, and early outcomes were compared based on LVEF. The primary outcome measure was good functional outcome (discharge modified Rankin Scale=0-2). Pearson chi-square and Kruskal-Wallis tests were used to compare groups.

Results RESULTS: Of 590 patients screened, 517 were included (mean age 65, 74% black, 48% female). Baseline factors associated with low LVEF included male gender (p<0.0005) and lower HDL (p<0.0005). Cardioembolic etiology of stroke was associated with a low LVEF (85% severely low vs. 42% moderately low vs. 19% normal, p<0.0005). Baseline National Institutes of Health Stroke Scale (NIHSS) distribution was greatest among severely low LVEF patients (p=0.010). Rates of MI (15% vs. 8% vs. 5%, p=0.022) and pneumonia (25% vs. 10% vs. 8%, p<0.0005) were higher in patients with severely low LVEF. A smaller proportion of patients with severely low LVEF had good functional outcome compared to the other groups (26% vs. 40% vs. 45%, p=0.028). After adjusting for age, baseline NIHSS and glucose, the relationship between LVEF and good functional outcome lost significance (OR 0.6, 95% CI 0.3-1.3, p=0.216).

Conclusions CONCLUSIONS: AIS patients with low LVEF have more complications and less often achieve good functional outcome. This association appears related to known predictors of poor functional outcome and is not significant once adjusting for these parameters.

Authors/Disclosures
Tiffany Mathias PRESENTER	No disclosure on file
Karen C. Albright, DO, DO, PhD, MS, MPH (FDA)	Dr. Albright has nothing to disclose.
	No disclosure on file
James E. Siegler III, MD (University of Chicago)	Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siegler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serb. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wallaby Phenox. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke: Vascular and Interventional Neurology. Dr. Siegler has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Precision Medicine, LLC. The institution of Dr. Siegler has received research support from Philips. The institution of Dr. Siegler has received research support from Medtronic.
Amelia K. Boehme, PhD (Columbia University)	Dr. Boehme has nothing to disclose.
Sheryl Martin-Schild, MD, PhD, FAAN (Dr. Brain, Inc.)	No disclosure on file
Michael S. Okun, MD, FAAN (University of Florida)	Dr. Okun has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Okun has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Parkinson's Foundation. Dr. Okun has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Okun has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Journal Watch. The institution of Dr. Okun has received research support from NIH. The institution of Dr. Okun has received research support from Parkinson's Foundation. The institution of Dr. Okun has received research support from Tourette Association of America. The institution of Dr. Okun has received research support from Michael J Fox. Dr. Okun has received publishing royalties from a publication relating to health care.

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