Prediction of long-term ischemic stroke with estimated whole blood viscosity in heart failure patients

Abstract

Aims: Heart failure (HF) and stroke often coexist and share common risk factors, including atrial fibrillation. Whole blood viscosity (WBV), one of the most significant indicators of endothelial stress, is a fundamental determinant of blood flow and is involved in the aetiology of atherosclerosis and thrombosis. The purpose of this study was to assess the association between estimated WBV and long-term ischemic stroke (IS) risk in patients hospitalized for acute HF. Methods: A total of 409 patients with reduced ejection fraction HF hospitalized with acute HF were included. The primary outcome was IS post-discharge follow-up. Results: IS occurred in 26 (6%) patients during a follow-up. In the IS group, older age, diabetes mellitus frequency and WBV were higher, left ventricular end-diastolic and left atrial anteroposterior diameter were increased and left ventricular ejection fraction was lower. In multivariate regression analysis, WBV was found to be a predictor of long-term IS (OR, 2.68; 95% CI, 1.96-3.12, p=0.008). In the receiver operating characteristic curve, the optimal cut-off value of WBV for one-year IS was 6.28 with 61.5% sensitivity and 70.2% specificity (area under the curve: 0.748). Conclusion: WBV is a novel, easily measurable, cost-effective, non-invasive risk marker for the prediction of long-term IS in patients with HF, independent of traditional risk factors.