{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:27:46Z","timestamp":1788546466996,"version":"build-2803163510"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":195,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000832","name":"Dowager Countess Eleanor Peel Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000832","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000832","name":"Dowager Countess Eleanor Peel Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000832","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The patient clinical phenotypes at particularly high risk for early cardiac complications after a recent acute ischaemic stroke (AIS), that is, stroke-heart syndrome (SHS), remain poorly defined. We utilised hierarchical cluster analysis to identify specific phenotypic profiles associated with this risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We gathered data on patients with AIS from the Virtual International Stroke Trials Archive, a global repository of clinical trial data. We examined cardiac complications within 30\u2009days post-stroke, including acute coronary syndrome, heart failure, arrhythmias and cardiorespiratory arrest. We employed hierarchical cluster analysis to define distinct phenotypic risk profiles. The incidence\/risk of SHS and 90-day mortality were compared across these profiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We included 12,482 patients (mean age 69\u2009\u00b1\u200912\u2009years; 55% male), yielding five phenotypes: Profile 1 (\u2018elderly and AF\u2019), Profile 2 (\u2018young and smoker\u2019), Profile 3 (\u2018young\u2019), Profile 4 (\u2018cardiac comorbidities\u2019) and Profile 5 (\u2018hypertension with atherosclerotic comorbidities\u2019). Profiles 4 and 1 exhibited the highest risk for SHS (adjusted HR (95% CI): 2.01 (1.70\u20132.38) and 1.26 (1.05\u20131.51), respectively, compared to Profile 3), while Profiles 5 and 2 showed moderate risk and Profile 3 had the lowest risk. Although Profiles 1 and 4 were at the highest risk for most SHS presentations, Profile 5 had the highest risk for cardiorespiratory arrest (adjusted HR (95% CI): 2.99 (1.22\u20137.34)). The 90-day mortality risk was stratified by phenotype, with the highest risk observed in Profiles 5, and 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Hierarchical cluster analysis effectively identified phenotypes with the highest risk of SHS and early mortality in patients with AIS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873241290440","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T01:22:00Z","timestamp":1728868920000},"page":"478-486","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Stroke-heart syndrome and early mortality in patients with acute ischaemic stroke using hierarchical cluster analysis: An individual patient data pooled analysis from the VISTA database"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4597-7862","authenticated-orcid":false,"given":"Hironori","family":"Ishiguchi","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK 1"},{"name":"Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan 2"},{"name":"Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bi","family":"Huang","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK 1"},{"name":"Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wahbi K.","family":"El-Bouri","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK 1"},{"name":"Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK 1"},{"name":"Danish Centre for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1318-4027","authenticated-orcid":false,"given":"Azmil H.","family":"Abdul-Rahim","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK 1"},{"name":"Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK 3"},{"name":"Stroke Division, Department Medicine for Older People, Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, UK 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of VISTA Collaborators*","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,1]]},"reference":[{"key":"2026012113081820400_bibr1-23969873241290440","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1161\/STROKEAHA.106.471813","article-title":"Predictors of early cardiac morbidity and mortality after ischemic stroke","volume":"38","author":"Prosser","year":"2007","journal-title":"Stroke"},{"key":"2026012113081820400_bibr2-23969873241290440","doi-asserted-by":"crossref","first-page":"2768","DOI":"10.1016\/j.jacc.2020.10.009","article-title":"Post-stroke cardiovascular complications and neurogenic cardiac injury: JACC state-of-the-art review","volume":"76","author":"Sposato","year":"2020","journal-title":"J Am Coll 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