PMID- 18294489
OWN - NLM
STAT- MEDLINE
DCOM- 20080313
LR  - 20131121
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 155
IP  - 3
DP  - 2008 Mar
TI  - Poor functional status based on the New York Heart Association classification 
      exposes the coronary patient to an elevated risk of ischemic stroke.
PG  - 515-20
LID - 10.1016/j.ahj.2007.10.032 [doi]
AB  - BACKGROUND: Patients with coronary heart disease (CHD) are at increased risk of 
      stroke. We investigated in a large cohort of patients with CHD the relationship 
      between functional status, as assessed by the New York Heart Association (NYHA) 
      classification, and incident ischemic stroke. METHODS: We followed up 15,524 
      patients with documented CHD, screened for inclusion in a clinical trial 
      (Bezafibrate Infarction Prevention), for 4.8 to 8.1 years. Functional status at 
      baseline was categorized according to the NYHA classification. Among 14,703 
      patients, free of stroke, with recorded NYHA functional class, 1086 (7.4%) 
      developed an ischemic cerebrovascular event, of whom 604 (4.1%) patients were 
      confirmed to have an ischemic stroke or transient ischemic attack. RESULTS: The 
      cumulative rate of ischemic cerebrovascular events increased from 6.7% in 
      patients with NYHA functional class I to 9.2% and 9.7% for patients with NYHA 
      functional classes II and III, respectively (P < .001). Adjustments were made in 
      Cox proportional hazard models for age, sex, body mass index, past myocardial 
      infarction, current smoking, diabetes, hypertension, peripheral vascular disease, 
      percent of cholesterol in high-density lipoprotein, and triglyceride levels. The 
      adjusted hazard ratios associated with NYHA functional class II and III were 1.29 
      (95% confidence interval 1.12-1.48) and 1.71 (95% confidence interval 1.36-2.15), 
      respectively, as compared with patients with NYHA class I. CONCLUSIONS: Our 
      findings indicate that stable coronary patients with even a slight limitation 
      based on the NYHA functional class are exposed to an increased risk of ischemic 
      stroke.
FAU - Koren-Morag, Nira
AU  - Koren-Morag N
AD  - Division of Epidemiology, Sackler Medical Faculty, Tel Aviv University, Tel Aviv, 
      Israel.
FAU - Goldbourt, Uri
AU  - Goldbourt U
FAU - Tanne, David
AU  - Tanne D
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20080131
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Hypolipidemic Agents)
RN  - Y9449Q51XH (Bezafibrate)
SB  - IM
MH  - Aged
MH  - Bezafibrate/*therapeutic use
MH  - Brain Ischemia/epidemiology/*etiology/prevention & control
MH  - Confidence Intervals
MH  - Coronary Disease/classification/*complications/drug therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Rate/*physiology
MH  - Humans
MH  - Hypolipidemic Agents/*therapeutic use
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Societies, Medical
MH  - Time Factors
EDAT- 2008/02/26 09:00
MHDA- 2008/03/14 09:00
CRDT- 2008/02/26 09:00
PHST- 2007/04/11 00:00 [received]
PHST- 2007/10/24 00:00 [accepted]
PHST- 2008/02/26 09:00 [pubmed]
PHST- 2008/03/14 09:00 [medline]
PHST- 2008/02/26 09:00 [entrez]
AID - S0002-8703(07)00865-4 [pii]
AID - 10.1016/j.ahj.2007.10.032 [doi]
PST - ppublish
SO  - Am Heart J. 2008 Mar;155(3):515-20. doi: 10.1016/j.ahj.2007.10.032. Epub 2008 Jan 
      31.