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BMC Neurology
Published in: BMC Neurology 1/2015

Open Access 01-12-2015 | Research article

Impact of chronic inflammatory airway disease on stroke severity and long-term survival after ischemic stroke - a retrospective analysis

Authors: Karl Georg Haeusler, Juliane Herm, Maria Konieczny, Ulrike Grittner, Mitja Lainscak, Matthias Endres, Wolfram Doehner

Published in: BMC Neurology | Issue 1/2015

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Abstract

Background

Chronic inflammatory airway disease (CIAD) has emerged as independent risk factor for cardiovascular mortality and ischemic stroke but the impact of co-existing CIAD in patients with ischemic stroke is less clear.

Methods

We retrospectively analyzed 1013 patients with acute ischemic stroke who were consecutively admitted to the Department of Neurology, Charité - Universitätsmedizin Berlin, Germany within one year. Mean follow-up was 80 months (IQR 32–85 months). Using multivariable regression models we analyzed the impact of CIAD (defined as chronic obstructive pulmonary disease or asthma bronchiale) on stroke severity and outcome.

Results

Co-existing CIAD was evident in 7.1 % (n = 72) of all patients with acute ischemic stroke. Baseline characteristics of stroke patients with CIAD did not differ significantly from ischemic stroke patients without CIAD. Age (OR 1.17 [95 % CI 1.03-1.37] per decade), atrial fibrillation (OR 3.43 [95 % CI 2.47-4.78]) and coronary artery disease (OR 1.51 [95 % CI 1.07–2.14]) but not a history of CIAD (p = 0.30) were associated with severe stroke (NIHSS≥11) on hospital admission. Age (HR 1.70 [95 % CI 1.53-1.87] per decade), peripheral artery disease (HR 1.91 [95 % CI 1.35-2.7]), stroke severity at hospital admission (NIHSS per point HR 1.08 [95 % CI 1.06-1.10]), and history of CIAD (HR 1.43 [95 % CI 1.02-2.00]) were independently associated with mortality during long-term follow-up. However, CIAD was not significantly associated with short-term mortality after stroke.

Conclusion

Co-existing CIAD showed no significant association with stroke severity at hospital admission and early mortality after ischemic stroke. CIAD was negatively associated with long-term survival after ischemic stroke.
Literature
1.
Cosio BG, Agustí A. Update in chronic obstructive pulmonary disease 2009. Am J Respir Crit Care Med. 2010;181:655–60.CrossRefPubMed
2.
Heuschmann PU, Neuhauser HK, Endres M. Development of mortality and morbidity of vascular diseases: variations between coronary heart disease and stroke. Nervenarzt. 2011;82(145–146):148–52.
3.
Finkelstein J, Cha E, Scharf SM. Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity. Int J Chron Obs Pulmon Dis. 2009;4:337–49.CrossRef
4.
Feary JR, Rodrigues LC, Smith CJ, Hubbard RB, Gibson JE. Prevalence of major comorbidities in subjects with COPD and incidence of myocardial infarction and stroke: a comprehensive analysis using data from primary care. Thorax. 2010;65:956–62.CrossRefPubMed
5.
Piñol-Ripoll G, de la Puerta I, Santos S, Purroy F, Mostacero E. Chronic bronchitis and acute infections as new risk factors for ischemic stroke and the lack of protection offered by the influenza vaccination. Cerebrovasc Dis. 2008;26:339–47.CrossRefPubMed
6.
Schneider C, Bothner U, Jick SS, Meier CR. Chronic obstructive pulmonary disease and the risk of cardiovascular diseases. Eur J Epidemiol. 2010;25:253–60.CrossRefPubMed
7.
Schnell K, Weiss CO, Lee T, Krishnan JA, Leff B, Wolff JL, et al. The prevalence of clinically-relevant comorbid conditions in patients with physician-diagnosed COPD: a cross-sectional study using data from NHANES 1999–2008. BMC Pulm Med. 2012;12:26.CrossRefPubMedPubMedCentral
8.
Yin L, Lensmar C, Ingelsson E, Bäck M. Differential association of chronic obstructive pulmonary disease with myocardial infarction and ischemic stroke in a nation-wide cohort. Int J Cardiol. 2014;173:601–3.CrossRefPubMed
9.
Doehner W, Haeusler KG, Endres M, Anker SD, MacNee W, Lainscak M. Neurological and endocrinological disorders: orphans in chronic obstructive pulmonary disease. Respir Med. 2011;105(Suppl):S12–9.CrossRefPubMed
10.
Lainscak M, Dagres N, Filippatos GS, Anker SD, Kremastinos DT. Atrial fibrillation in chronic non-cardiac disease: where do we stand? Int J Cardiol. 2008;128:311–5.CrossRefPubMed
11.
Lindsberg PJ, Grau AJ. Inflammation and infections as risk factors for ischemic stroke. Stroke. 2003;34:2518–32.CrossRefPubMed
12.
Sin DD, Anthonisen NR, Soriano JB, Agusti AG. Mortality in COPD: Role of comorbidities. Eur Respir J. 2006;28:1245–57.CrossRefPubMed
13.
Hozawa A, Billings JL, Shahar E, Ohira T, Rosamond WD, Folsom AR. Lung function and ischemic stroke incidence: the Atherosclerosis Risk in Communities study. Chest. 2006;130:1642–9.CrossRefPubMed
14.
Donaldson GC, Hurst JR, Smith CJ, Hubbard RB, Wedzicha JA. Increased risk of myocardial infarction and stroke following exacerbation of COPD. Chest. 2010;137:1091–7.CrossRefPubMed
15.
Roca B, Almagro P, López F, Cabrera FJ, Montero L, Morchón D, et al. Factors associated with mortality in patients with exacerbation of chronic obstructive pulmonary disease hospitalized in General Medicine departments. Intern Emerg Med. 2011;6:47–54.CrossRefPubMed
16.
Hole DJ, Watt GC, Davey-Smith G, Hart CL, Gillis CR, Hawthorne VM. Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ. 1996;313:711–5. discussion 715–6.CrossRefPubMedPubMedCentral
17.
Finlayson O, Kapral M, Hall R, Asllani E, Selchen D, Saposnik G. Risk factors, inpatient care, and outcomes of pneumonia after ischemic stroke. Neurology. 2011;77:1338–45.CrossRefPubMed
18.
Katzan IL, Cebul RD, Husak SH, Dawson NV, Baker DW. The effect of pneumonia on mortality among patients hospitalized for acute stroke. Neurology. 2003;60:620–5.CrossRefPubMed
19.
Brott T, Adams HP, Olinger CP, Marler JR, Barsan WG, Biller J, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20:864–70.CrossRefPubMed
20.
Haeusler KG, Konieczny M, Endres M, Villringer A, Heuschmann PU. Impact of anticoagulation before stroke on stroke severity and long-term survival. Int J Stroke. 2012;7:544–50.CrossRefPubMed
21.
Van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988;19:604–7.CrossRefPubMed
22.
van Wijk I, Kappelle LJ, Van Gijn J, Koudstaal PJ, Franke CL, Vermeulen M, et al. Long-term survival and vascular event risk after transient ischaemic attack or minor ischaemic stroke: a cohort study. Lancet. 2005;365:2098–104.CrossRefPubMed
23.
Koton S, Tanne D, Green MS, Bornstein NM. Mortality and predictors of death 1 month and 3 years after first-ever ischemic stroke: data from the first national acute stroke Israeli survey (NASIS 2004). Neuroepidemiology. 2010;34:90–6.CrossRefPubMed
24.
Andersen KK, Andersen ZJ, Olsen TS. Predictors of early and late case-fatality in a nationwide Danish study of 26,818 patients with first-ever ischemic stroke. Stroke. 2011;42:2806–12.CrossRefPubMed
25.
Marini C, De Santis F, Sacco S, Russo T, Olivieri L, Totaro R, et al. Contribution of atrial fibrillation to incidence and outcome of ischemic stroke: results from a population-based study. Stroke. 2005;36:1115–9.CrossRefPubMed
26.
Anecchino C, Rossi E, Fanizza C, De Rosa M, Tognoni G, Romero M. Prevalence of chronic obstructive pulmonary disease and pattern of comorbidities in a general population. Int J Chron Obs Pulmon Dis. 2007;2:567–74.
27.
28.
Ringleb PA, Bousser MG, Ford G, Bath P, Brainin M, Caso V, et al. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis. 2008;25:457–507.CrossRef
29.
White WB, Cooke GE, Kowey PR, Calverley PMA, Bredenbröker D, Goehring U-M, et al. Cardiovascular safety in patients receiving roflumilast for the treatment of COPD. Chest. 2013;144:758–65.CrossRefPubMed
30.
Ingelsson E, Yin L, Bäck M. Nationwide cohort study of the leukotriene receptor antagonist montelukast and incident or recurrent cardiovascular disease. J Allergy Clin Immunol. 2012;129:702–7. e2.CrossRefPubMed
31.
Sin DD, Man SFP. Chronic obstructive pulmonary disease as a risk factor for cardiovascular morbidity and mortality. Proc Am Thorac Soc. 2005;2:8–11.CrossRefPubMed
32.
Curkendall SM, DeLuise C, Jones JK, Lanes S, Stang MR, Goehring E, et al. Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients. Ann Epidemiol. 2006;16:63–70.CrossRefPubMed
33.
Cavanaugh KL, Merkin SS, Plantinga LC, Fink NE, Sadler JH, Powe NR. Accuracy of patients’ reports of comorbid disease and their association with mortality in ESRD. Am J Kidney Dis. 2008;52:118–27.CrossRefPubMedPubMedCentral
Metadata
Title
Impact of chronic inflammatory airway disease on stroke severity and long-term survival after ischemic stroke - a retrospective analysis
Authors
Karl Georg Haeusler
Juliane Herm
Maria Konieczny
Ulrike Grittner
Mitja Lainscak
Matthias Endres
Wolfram Doehner
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2015
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-015-0414-1

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