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
IntroductionHeart 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.MethodsWe searched three databas...
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.967197/full |
| _version_ | 1811261867627118592 |
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| author | Sean Tan Clare Elisabeth Si Min Ho Yao Neng Teo Yao Hao Teo Mark Yan-Yee Chan Mark Yan-Yee Chan Chi-Hang Lee Chi-Hang Lee Lauren Kay Mance Evangelista Weiqin Lin Weiqin Lin Yao-Feng Chong Tiong-Cheng Yeo Tiong-Cheng Yeo Vijay Kumar Sharma Vijay Kumar Sharma Raymond C. C. Wong Raymond C. C. Wong Benjamin Y. Q. Tan Benjamin Y. Q. Tan Leonard L. L. Yeo Leonard L. L. Yeo Ping Chai Ping Chai Ching-Hui Sia Ching-Hui Sia |
| author_facet | Sean Tan Clare Elisabeth Si Min Ho Yao Neng Teo Yao Hao Teo Mark Yan-Yee Chan Mark Yan-Yee Chan Chi-Hang Lee Chi-Hang Lee Lauren Kay Mance Evangelista Weiqin Lin Weiqin Lin Yao-Feng Chong Tiong-Cheng Yeo Tiong-Cheng Yeo Vijay Kumar Sharma Vijay Kumar Sharma Raymond C. C. Wong Raymond C. C. Wong Benjamin Y. Q. Tan Benjamin Y. Q. Tan Leonard L. L. Yeo Leonard L. L. Yeo Ping Chai Ping Chai Ching-Hui Sia Ching-Hui Sia |
| author_sort | Sean Tan |
| collection | DOAJ |
| description | IntroductionHeart 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.MethodsWe 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.ResultsIn 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.ConclusionWe obtained estimates for the prevalence of IS, WMH, and SBI in HF from systematic review of the literature.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=255126, PROSPERO [CRD42021255126]. |
| first_indexed | 2024-04-12T19:13:36Z |
| format | Article |
| id | doaj.art-69eda916e7da451889834c46a7fd77b7 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T19:13:36Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-69eda916e7da451889834c46a7fd77b72022-12-22T03:19:48ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-09-01910.3389/fcvm.2022.967197967197Prevalence and incidence of stroke, white matter hyperintensities, and silent brain infarcts in patients with chronic heart failure: A systematic review, meta-analysis, and meta-regressionSean Tan0Clare Elisabeth Si Min Ho1Yao Neng Teo2Yao Hao Teo3Mark Yan-Yee Chan4Mark Yan-Yee Chan5Chi-Hang Lee6Chi-Hang Lee7Lauren Kay Mance Evangelista8Weiqin Lin9Weiqin Lin10Yao-Feng Chong11Tiong-Cheng Yeo12Tiong-Cheng Yeo13Vijay Kumar Sharma14Vijay Kumar Sharma15Raymond C. C. Wong16Raymond C. C. Wong17Benjamin Y. Q. Tan18Benjamin Y. Q. Tan19Leonard L. L. Yeo20Leonard L. L. Yeo21Ping Chai22Ping Chai23Ching-Hui Sia24Ching-Hui Sia25Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore, SingaporeDivision of Neurology, University Medicine Cluster, National University Health System, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDivision of Neurology, University Medicine Cluster, National University Health System, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDivision of Neurology, University Medicine Cluster, National University Health System, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDivision of Neurology, University Medicine Cluster, National University Health System, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore, SingaporeIntroductionHeart 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.MethodsWe 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.ResultsIn 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.ConclusionWe obtained estimates for the prevalence of IS, WMH, and SBI in HF from systematic review of the literature.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=255126, PROSPERO [CRD42021255126].https://www.frontiersin.org/articles/10.3389/fcvm.2022.967197/fullheart failureischemic strokewhite matter hyperintensitiessilent strokeprevalence |
| spellingShingle | Sean Tan Clare Elisabeth Si Min Ho Yao Neng Teo Yao Hao Teo Mark Yan-Yee Chan Mark Yan-Yee Chan Chi-Hang Lee Chi-Hang Lee Lauren Kay Mance Evangelista Weiqin Lin Weiqin Lin Yao-Feng Chong Tiong-Cheng Yeo Tiong-Cheng Yeo Vijay Kumar Sharma Vijay Kumar Sharma Raymond C. C. Wong Raymond C. C. Wong Benjamin Y. Q. Tan Benjamin Y. Q. Tan Leonard L. L. Yeo Leonard L. L. Yeo Ping Chai Ping Chai Ching-Hui Sia Ching-Hui Sia 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 heart failure ischemic stroke white matter hyperintensities silent stroke prevalence |
| 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | heart failure ischemic stroke white matter hyperintensities silent stroke prevalence |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.967197/full |
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