Predictors of ischemic stroke in patients with aortic stenosis: results of a single-center retrospective study

Aortic stenosis (AS), the prevalence of which increases with age, raises the risk of developing ischaemic stroke (IS), but the risk factors for cerebral ischemic events have not been fully established.

Objective: to evaluate IS predictors in patients with moderate or severe AS, which will help identify high-risk groups and optimise stroke prevention.

Material and methods. A retrospective review of data from the hospital information system for case-control analysis was conducted at one of the Federal Centers for Cardiovascular Surgery. Inclusion criteria: moderate or severe AS, patient age ≥18 years. Exclusion criteria: moderate or severe mitral stenosis, moderate or severe mitral regurgitation. Logistic regression was used to determine IS predictors. Odds ratio (OR) with 95% confidence intervals (CI) were calculated for each of the significant risk factors.

Results. The study included 208 patients with AS (the main group consisted of 51 patients with a history of IS or transient ischemic attack). The median age of patients was 68 [62.0; 72.0] years, the proportion of men was 53.8%. According to the multivariate analysis, the following predictors of cerebral ischemic events were identified: male gender (OR 2.739; 95% CI 1.048–7.156, p=0.040), extra-, intracranial stenosis >50% (OR 2.488; 95% CI 1.089–5.686, p=0.031), aortic arch atheromas (OR 5.947; 95% CI 1.179–29.994, p=0.031), the result of the CHA2DS2VASc scale with an increase of 1 point (OR 4.030; 95% CI 1.912–8.499, p<0.001).

Conclusion. Supra-cardiac atherosclerosis (extraand intracranial atherosclerosis, aortic atheromas) is the main predictor of IS in patients with AS, which determines the need for its assessment in order to optimise patient treatment.

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