AUTHOR=Tan Sean , Ho Clare Elisabeth Si Min , Teo Yao Neng , Teo Yao Hao , Chan Mark Yan-Yee , Lee Chi-Hang , Evangelista Lauren Kay Mance , Lin Weiqin , Chong Yao-Feng , Yeo Tiong-Cheng , Sharma Vijay Kumar , Wong Raymond C. C. , Tan Benjamin Y. Q. , Yeo Leonard L. L. , Chai Ping , Sia Ching-Hui 

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

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.967197

DOI=10.3389/fcvm.2022.967197

ISSN=2297-055X

ABSTRACT=Introduction: Heart failure (HF) is associated with ischaemic stroke (IS). However, there are limited studies on prevalence of IS, white matter hyperintensities (WMHs) and silent brain infarcts (SBIs). Furthermore, interaction with ejection fraction (EF) is unclear. 

Methods: We searched 3 databases (PubMed, Embase, Cochrane) for studies reporting incidence or prevalence of IS, WMH, SBIs in HF. Two authors independently selected studies for inclusion. We used random-effects models and heterogeneity was evaluated with I2. 

Results: 41 articles with 870,002 patients were retrieved from 15,267 records. Among HF patients, pooled proportion of IS was 4.06% (95% CI: 2.94–5.59), WMH and SBI were significantly higher at 15.67% (95% CI: 4.11-44.63) and 23.45% (95% CI: 14.53-35.58). Sub-group analysis of HFpEF and HFrEF revealed pooled prevalence of 2.97% (95% CI: 2.01–4.39) and 3.69% (95% CI: 2.34–5.77). Subgroup analysis of WMH with Fazekas Score 1, 2, 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). Relative risk and hazard ratio of HF patients developing IS were 2.29 (95% CI: 1.43-3.68) and 1.63 (95% CI: 1.22-2.18). 

Conclusion: We obtained estimates for prevalence of IS, WMH, SBI in HF from systematic review of literature.