Anton Schmick, Marco Heinrich Rohner, Catherine Gebhard, Andreas R Luft, Susanne Wegener
In this single-center cohort of patients without known heart disease and noncardioembolic AIS, poststroke cardiac findings were more common in men, particularly nonsustained ventricular tachycardia and polymorphic ventricular extrasystoles. These hypothesis-generating observations support further investigation into sex-informed poststroke cardiac evaluation.
BACKGROUND: Cardiac pathologies can occur after acute ischemic stroke (AIS) even in patients without prior heart disease, reflecting bidirectional brain-heart interactions. We investigated sex-specific differences in newly diagnosed cardiac pathologies within 1 year after noncardioembolic AIS.
METHODS: We screened 7113 patients with a first cerebrovascular event (December 2013 to March 2021) at a tertiary stroke center and included 673 patients (39% women, aged 61.2 years) with noncardioembolic AIS and no evidence of previous cardiac disease. After AIS, all patients received standard cardiologic evaluation (24-hour in-hospital telemetry, 24-hour blood pressure monitoring, echocardiography, and 48-hour Holter ECG). Electronic health records were reviewed for cardiology consultations and testing within 1 year after the index event (eg, ECG, echocardiography, coronary computed tomographic angiography, cardiac magnetic resonance imaging, myocardial perfusion single-photon emission computed tomography). Multivariable binary logistic regression models were adjusted for age, antihypertensive and lipid-lowering therapy, hypertension, diabetes, hyperlipidemia, and smoking.
RESULTS: Compared with women, men more frequently exhibited nonsustained ventricular tachycardia (odds ratio, 3.97 [95% CI, 1.14-13.86]; P=0.031), first-degree atrioventricular block (odds ratio, 5.71 [95% CI, 1.48-22.01]; P=0.013), bradycardia (odds ratio, 3.40 [95% CI, 1.50-7.67]; P=0.003), and polymorphic ventricular extrasystoles (odds ratio, 2.61 [95% CI, 1.43-4.74]; P=0.002) within 1 year after AIS. Findings were consistent after multivariable adjustment.
CONCLUSIONS: In this single-center cohort of patients without known heart disease and noncardioembolic AIS, poststroke cardiac findings were more common in men, particularly nonsustained ventricular tachycardia and polymorphic ventricular extrasystoles. These hypothesis-generating observations support further investigation into sex-informed poststroke cardiac evaluation.