{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T07:03:46Z","timestamp":1789628626879,"version":"build-2803163510"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>The risk of major adverse cardiovascular events is substantially increased following a stroke. Although exercise-based cardiac rehabilitation has been shown to improve prognosis following cardiac events, it is not part of routine care for people following a stroke. We, therefore, investigated the association between cardiac rehabilitation and major adverse cardiovascular events for people following a stroke. Following a stroke, individuals have an increased risk of new-onset cardiovascular complications. However, the incidence and long-term clinical consequence of newly diagnosed cardiovascular complications following a stroke is unclear. The aim of the present study was to investigate the incidence and long-term clinical outcomes of newly diagnosed cardiovascular complications following incident ischemic stroke.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A retrospective cohort study was conducted using anonymized electronic medical records from 53 participating health care organizations. Patients with incident ischemic stroke aged \u226518 years with 5 years of follow-up were included. Patients who were diagnosed with new-onset cardiovascular complications (heart failure, severe ventricular arrhythmia, atrial fibrillation, ischemic heart disease, Takotsubo syndrome) within 4-weeks (exposure) of incident ischemic stroke were 1:1 propensity score-matched (age, sex, ethnicity, comorbidities, cardiovascular care) with ischemic stroke patients who were not diagnosed with a new-onset cardiovascular complication (control). Logistic regression models produced odds ratios (OR) with 95% CIs for 5-year incidence of all-cause mortality, recurrent stroke, hospitalization, and acute myocardial infarction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Of 365\u2009383 patients with stroke with 5-year follow-up: 11.1% developed acute coronary syndrome; 8.8% atrial fibrillation\/flutter; 6.4% heart failure; 1.2% severe ventricular arrythmias; and 0.1% Takotsubo syndrome within 4 weeks of incident ischemic stroke. Following propensity score matching, odds of 5-year all-cause mortality were significantly higher in stroke patients with acute coronary syndrome (odds ratio, 1.49 [95% CI, 1.44\u20131.54]), atrial fibrillation\/flutter (1.45 [1.40\u20131.50]), heart failure (1.83 [1.76\u20131.91]), and severe ventricular arrhythmias (2.08 [1.90\u20132.29]), compared with matched controls. Odds of 5-year rehospitalization and acute myocardial infarction were also significantly higher for patients with stroke diagnosed with new-onset cardiovascular complications. Takotsubo syndrome was associated with significantly higher odds of 5-year composite major adverse cardiovascular events (1.89 [1.29\u20132.77]). Atrial fibrillation\/flutter was the only new-onset cardiac complication associated with significantly higher odds of recurrent ischemic stroke at 5 years (1.10 [1.07\u20131.14]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>New-onset cardiovascular complications diagnosed following an ischemic stroke are very common and associate with significantly worse 5-year prognosis in terms of major adverse cardiovascular events. People with stroke and newly diagnosed cardiovascular complications had &gt;50% prevalence of recurrent stroke at 5 years.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.121.037316","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T09:01:47Z","timestamp":1648717307000},"page":"1759-1763","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":139,"title":["Stroke-Heart Syndrome: Incidence and Clinical Outcomes of Cardiac Complications Following Stroke"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1479-8872","authenticated-orcid":true,"given":"Benjamin J.R.","family":"Buckley","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital (B.J.R.B, S.L.H., D.A.L., G.Y.H.L.), University of Liverpool, United Kingdom."},{"name":"Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences (B.J.R.B., S.L.H., D.A.L., G.Y.H.L.), University of Liverpool, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital (B.J.R.B, S.L.H., D.A.L., G.Y.H.L.), University of Liverpool, United Kingdom."},{"name":"Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences (B.J.R.B., S.L.H., D.A.L., G.Y.H.L.), University of Liverpool, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2875-0546","authenticated-orcid":true,"given":"Andrew","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Medicine for Older People, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, United Kingdom (A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Underhill","sequence":"additional","affiliation":[{"name":"TriNetX LLC, London, United Kingdom (P.U.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5604-9378","authenticated-orcid":true,"given":"Deirdre A.","family":"Lane","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital (B.J.R.B, S.L.H., D.A.L., G.Y.H.L.), University of Liverpool, United Kingdom."},{"name":"Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences (B.J.R.B., S.L.H., D.A.L., G.Y.H.L.), University of Liverpool, United Kingdom."},{"name":"Department of Clinical Medicine, Aalborg University, Denmark (D.A.L., G.Y.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":true,"given":"Gregory Y.H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital (B.J.R.B, S.L.H., D.A.L., G.Y.H.L.), University of Liverpool, United Kingdom."},{"name":"Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences (B.J.R.B., S.L.H., D.A.L., G.Y.H.L.), University of Liverpool, United Kingdom."},{"name":"Department of Clinical Medicine, Aalborg University, Denmark (D.A.L., G.Y.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70266-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30336-3"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.106.471813"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.10.009"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.033970"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000521025"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-11-105"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.121.037316","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T08:22:27Z","timestamp":1738830147000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.121.037316"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1161\/STROKEAHA.121.037316"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.121.037316","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5]]},"assertion":[{"value":"2021-11-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-28","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}