TY - JOUR
T1 - The association between pulmonary hypertension and stroke
T2 - A systematic review and meta-analysis
AU - Shah, Trushil G.
AU - Sutaria, Jaini M.
AU - Vyas, Manav V.
N1 - Funding Information:
TGS has received funding from National Institutes for Health, Actelion Pharamaceuticals, Bayer Pharamaceuticals and Liquidia technologies. TGS has also served on speakers' bureau and advisory board for Gilead sciences.
Funding Information:
MVV was funded by Heart & Stroke Richard Lewar Centre of Excellence/CANHEART SPOR Studentship Award, and Canadian Institutes of Health Research (CIHR) Fellowship Award.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/11/15
Y1 - 2019/11/15
N2 - Background: Pulmonary hypertension is associated with atrial fibrillation and paradoxical embolism. Yet, the association between pulmonary hypertension and stroke has not been well studied. Methods: We reviewed Medline and Embase from inception to December 1, 2018, to identify observational studies reporting prevalence of stroke in adult patients with pulmonary hypertension. We sought studies that included patients with pulmonary hypertension secondary to any etiology except left heart failure, and excluded studies that reported rates of perioperative stroke. We conducted random effects meta-analyses to obtain pooled prevalence of stroke in patients with pulmonary hypertension, and pooled unadjusted odds ratio of stroke in patients with pulmonary hypertension compared to those without. Results: We included 14 studies including 32,523 participants of which 2976 (9.2%) had pulmonary hypertension, and 727 (2.2%) had a stroke. The pooled prevalence of stroke in patients with pulmonary hypertension was 8.0% [95% confidence interval (CI), 5.1%–10.9%, I2 91.9]. The pooled unadjusted odds ratio of stroke in patients with pulmonary hypertension compared to those without was 1.46 (95% CI, 1.07–1.99, I2 55.6, n = 7 studies). Conclusion: Stroke is a major non-cardiac morbidity in patients with pulmonary hypertension, requiring further evaluation to determine its etiology, and measures to reduce its risk.
AB - Background: Pulmonary hypertension is associated with atrial fibrillation and paradoxical embolism. Yet, the association between pulmonary hypertension and stroke has not been well studied. Methods: We reviewed Medline and Embase from inception to December 1, 2018, to identify observational studies reporting prevalence of stroke in adult patients with pulmonary hypertension. We sought studies that included patients with pulmonary hypertension secondary to any etiology except left heart failure, and excluded studies that reported rates of perioperative stroke. We conducted random effects meta-analyses to obtain pooled prevalence of stroke in patients with pulmonary hypertension, and pooled unadjusted odds ratio of stroke in patients with pulmonary hypertension compared to those without. Results: We included 14 studies including 32,523 participants of which 2976 (9.2%) had pulmonary hypertension, and 727 (2.2%) had a stroke. The pooled prevalence of stroke in patients with pulmonary hypertension was 8.0% [95% confidence interval (CI), 5.1%–10.9%, I2 91.9]. The pooled unadjusted odds ratio of stroke in patients with pulmonary hypertension compared to those without was 1.46 (95% CI, 1.07–1.99, I2 55.6, n = 7 studies). Conclusion: Stroke is a major non-cardiac morbidity in patients with pulmonary hypertension, requiring further evaluation to determine its etiology, and measures to reduce its risk.
KW - Meta-analysis
KW - Observational studies
KW - Pulmonary hypertension
KW - Stroke
KW - Systematic review
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U2 - 10.1016/j.ijcard.2019.07.085
DO - 10.1016/j.ijcard.2019.07.085
M3 - Article
C2 - 31402157
AN - SCOPUS:85070216223
SN - 0167-5273
VL - 295
SP - 21
EP - 24
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -