PMID- 32163672 OWN - NLM STAT- MEDLINE DCOM- 20210621 LR - 20210621 IS - 2055-5822 (Electronic) IS - 2055-5822 (Linking) VI - 7 IP - 3 DP - 2020 Jun TI - Non-invasive telemedical care in heart failure patients and stroke: post hoc analysis of TIM-HF and TIM-HF2 trials. PG - 884-891 LID - 10.1002/ehf2.12679 [doi] AB - AIMS: Patients with chronic heart failure (CHF) have an increased risk of ischaemic stroke. We aimed to identify the incidence rate and factors associated with ischaemic stroke or transient ischaemic attack (TIA) in CHF patients as well as the impact of non-invasive telemedical care (NITC) on acute stroke/TIA. METHODS AND RESULTS: We retrospectively analysed baseline characteristics of 2248 CHF patients enrolled to the prospective multicentre Telemedical Interventional Monitoring in Heart Failure study (TIM-HF) and Telemedical Interventional Management in Heart Failure II study (TIM-HF2), randomizing New York Heart Association (NYHA) II/III patients 1:1 to NITC or standard of care. Hospitalizations due to acute ischaemic stroke or TIA during a follow-up of 12 months were analysed. Old age, hyperlipidaemia, lower body mass index, and peripheral arterial occlusive disease (PAOD) were independently associated with present cerebrovascular disease on enrolment. The stroke/TIA rate was 1.5 per 100 patients-years within 12 months after randomization (n = 32, 1.4%). Rate of stroke/TIA within 12 months was in the intervention group similar compared with the control group (50.0% vs. 49.8%; P = 0.98) despite that the rate of newly detected atrial fibrillation (AF) was higher in the intervention group (14.1% vs. 1.6%; P < 0.001). A history of PAOD (OR 2.7, 95% CI 1.2-6.2; P = 0.02) and the highest tertile (OR 3.0, 95% CI 1.1-8.3) of N-terminal pro-brain natriuretic peptide (NT-proBNP) on enrolment were associated with stroke/TIA during follow-up. In patients who suffered acute stroke or TIA during follow-up, echocardiography was part of the diagnostic workup in only 56% after hospital admission. CONCLUSIONS: Annual rate of ischaemic stroke/TIA in NYHA II/III patients is low but higher in those with elevated NT-proBNP levels and history of PAOD at baseline. NITC showed no impact on the stroke rate during 1 year follow-up despite a significantly higher rate of newly detected AF. Irrespective of known CHF, echocardiography was often missing during in-hospital diagnostic workup after acute stroke/TIA. CI - (c) 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. FAU - Tutuncu, Serdar AU - Tutuncu S AD - Center for Stroke Research Berlin, Charite - Universitatsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany. FAU - Honold, Marcus AU - Honold M AD - Cardiologist in Private Practice, Gerlingen, Germany. FAU - Koehler, Kerstin AU - Koehler K AD - Center for Cardiovascular Telemedicine, Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. FAU - Deckwart, Oliver AU - Deckwart O AD - Center for Cardiovascular Telemedicine, Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. FAU - Koehler, Friedrich AU - Koehler F AD - Center for Cardiovascular Telemedicine, Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. FAU - Haeusler, Karl Georg AU - Haeusler KG AD - Department of Neurology, Universitatsklinikum Wurzburg, Wurzburg, Germany. LA - eng GR - 01MG531/Bundesministerium fur Forschung und Technologie/International GR - Robert Bosch Stiftung/International GR - Deutsche Telekom Healthcare & Security Solutions GmbH/International GR - Thermo Fisher Scientific/International GR - Germany Hasso-Plattner-Institut fur Softwaresystemtechnik GmbH/International GR - Teltow/International GR - GETEMED Medizin- und Informationstechnik AG/International GR - 13KQ1104A/Bundesministerium fur Bildung und Forschung/International GR - 13KQ0904B/Bundesministerium fur Bildung und Forschung/International GR - 13KQ0904A/Bundesministerium fur Bildung und Forschung/International GR - Aipermon GmbH & Co KG/International GR - InterComponentWare AG/International GR - Robert Bosch/International GR - 01MG531/Bundesministerium fur Wirtschaft und Technologie/International PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200312 PL - England TA - ESC Heart Fail JT - ESC heart failure JID - 101669191 SB - IM MH - *Brain Ischemia MH - *Heart Failure/epidemiology/therapy MH - Humans MH - Prospective Studies MH - Retrospective Studies MH - *Stroke/epidemiology/etiology PMC - PMC7261572 OTO - NOTNLM OT - Chronic heart failure OT - Ischaemic stroke OT - Telemedical Interventional Management in Heart Failure COIS- K. G. H. reports study grants by Bayer and Sanofi-Aventis, lecture fees/advisory board fees from Bayer, Sanofi-Aventis, Pfizer, Bristol-Myers-Squibb, Boehringer Ingelheim, Daiichi Sankyo, W.L. Gore & Associates, Biotronik, and Medtronic. S. T. reports lecture fees by Boehringer Ingelheim. O. D. has received personal fees and speakers' honoraria from Novartis Pharma GmbH. M. H. and K. K. have nothing to declare. EDAT- 2020/03/13 06:00 MHDA- 2021/06/22 06:00 PMCR- 2020/03/12 CRDT- 2020/03/13 06:00 PHST- 2019/06/06 00:00 [received] PHST- 2020/02/13 00:00 [revised] PHST- 2020/02/22 00:00 [accepted] PHST- 2020/03/13 06:00 [pubmed] PHST- 2021/06/22 06:00 [medline] PHST- 2020/03/13 06:00 [entrez] PHST- 2020/03/12 00:00 [pmc-release] AID - EHF212679 [pii] AID - 10.1002/ehf2.12679 [doi] PST - ppublish SO - ESC Heart Fail. 2020 Jun;7(3):884-891. doi: 10.1002/ehf2.12679. Epub 2020 Mar 12.