Please use this identifier to cite or link to this item: https://doi.org/10.3389/fcvm.2022.967197
Title: Prevalence and incidence of stroke, white matter hyperintensities, and silent brain infarcts in patients with chronic heart failure: A systematic review, meta-analysis, and meta-regression
Authors: Tan, Sean
Ho, Clare Elisabeth Si Min
Teo, Yao Neng
Teo, Yao Hao
Chan, Mark Yan-Yee 
Lee, Chi-Hang 
Evangelista, Lauren Kay Mance
Lin, Weiqin 
Chong, Yao-Feng 
Yeo, Tiong-Cheng 
Sharma, Vijay Kumar 
Wong, Raymond CC 
Tan, Benjamin YQ
Yeo, Leonard LL 
Chai, Ping 
Sia, Ching-Hui 
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
heart failure
ischemic stroke
white matter hyperintensities
silent stroke
prevalence
VENTRICULAR SYSTOLIC DYSFUNCTION
PRESERVED EJECTION FRACTION
HEALTH-CARE PROFESSIONALS
ISCHEMIC-STROKE
ATRIAL-FIBRILLATION
CEREBRAL INFARCTION
ORAL ANTICOAGULANTS
PRIMARY PREVENTION
ESC GUIDELINES
TERM RISK
Issue Date: 15-Sep-2022
Publisher: FRONTIERS MEDIA SA
Citation: Tan, Sean, Ho, Clare Elisabeth Si Min, Teo, Yao Neng, Teo, Yao Hao, Chan, Mark Yan-Yee, Lee, Chi-Hang, Evangelista, Lauren Kay Mance, Lin, Weiqin, Chong, Yao-Feng, Yeo, Tiong-Cheng, Sharma, Vijay Kumar, Wong, Raymond CC, Tan, Benjamin YQ, Yeo, Leonard LL, Chai, Ping, Sia, Ching-Hui (2022-09-15). Prevalence and incidence of stroke, white matter hyperintensities, and silent brain infarcts in patients with chronic heart failure: A systematic review, meta-analysis, and meta-regression. FRONTIERS IN CARDIOVASCULAR MEDICINE 9. ScholarBank@NUS Repository. https://doi.org/10.3389/fcvm.2022.967197
Abstract: Introduction: Heart failure (HF) is associated with ischemic stroke (IS). However, there are limited studies on the prevalence of IS, white matter hyperintensities (WMHs), and silent brain infarcts (SBIs). Furthermore, interaction with ejection fraction (EF) is unclear. Methods: We searched three databases (viz., PubMed, Embase, and Cochrane) for studies reporting the incidence or prevalence of IS, WMHs, and SBIs in HF. A total of two authors independently selected included studies. We used random-effects models, and heterogeneity was evaluated with I2 statistic. Meta-regression was used for subgroup analysis. Results: In total, 41 articles involving 870,002 patients were retrieved from 15,267 records. Among patients with HF, the pooled proportion of IS was 4.06% (95% CI: 2.94–5.59), and that of WMHs and SBIs was higher at 15.67% (95% CI: 4.11–44.63) and 23.45% (95% CI: 14.53–35.58), respectively. Subgroup analysis of HFpEF and HFrEF revealed a pooled prevalence of 2.97% (95% CI: 2.01–4.39) and 3.69% (95% CI: 2.34–5.77), respectively. Subgroup analysis of WMH Fazekas scores 1, 2, and 3 revealed a decreasing trend from 60.57 % (95% CI: 35.13–81.33) to 11.57% (95% CI: 10.40–12.85) to 3.07% (95% CI: 0.95–9.47). The relative risk and hazard ratio of patients with HF developing IS were 2.29 (95% CI: 1.43–3.68) and 1.63 (95% CI: 1.22–2.18), respectively. Meta-regression showed IS prevalence was positively correlated with decreasing anticoagulant usage. Conclusion: We obtained estimates for the prevalence of IS, WMH, and SBI in HF from systematic review of the literature. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=255126, PROSPERO [CRD42021255126].
Source Title: FRONTIERS IN CARDIOVASCULAR MEDICINE
URI: https://scholarbank.nus.edu.sg/handle/10635/233458
ISSN: 2297-055X
DOI: 10.3389/fcvm.2022.967197
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