Which factors were associated with stroke risk among older cardiology outpatients?

Details

The study aimed to identify risk factors for developing stroke in an outpatient cardiology practice. Researchers reviewed the charts of 1,599 patients: 1,138 men and 461 women, with a mean age of 72 ± 12 years. This was an observational chart-review study. Medication use and coexisting conditions were tabulated for each patient. Stepwise Cox regression analyses assessed 45 different variables for statistical significance. Mean follow-up was 63 ± 55 months during 1977–2009.

During follow-up, 48 of the 1,599 patients (3%) had a stroke. Stepwise Cox regression identified three statistically significant independent associations with new stroke: statin use was associated with lower risk (hazard ratio = 0.2656; 95% confidence interval, 0.1480–0.4766; p < 0.0001), while carotid artery stenosis (hazard ratio = 3.7292; 95% confidence interval, 1.7960–7.7433; p < 0.001) and congestive heart failure (hazard ratio = 2.1369; 95% confidence interval, 1.1046–4.1340; p < 0.05) were associated with higher risk.

The authors summarized the findings in this outpatient cardiology practice as a 73% lower incidence of stroke associated with statin use, and 3.7-fold and 2.1-fold higher risks of developing stroke associated with carotid artery stenosis and congestive heart failure, respectively.