Browsing by Author "Aje A."

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Echocardiographic abnormalities and determinants of 1-month outcome of stroke among West Africans in the SIREN Study
    (American Heart Association, 2019) Adeoye A. M.; Ovbiagele B.; Akinyemi J. O.; Ogah O. S.; Akinyemi R.; Gebregziabher M.; Wahab K.; Fakunle A. G.; Akintunde A.; Adebayo O.; Aje A.; Tiwari H. K; Arnett D.; Agyekum F.; Appiah L. T.; Amusa G.; Olunuga T. O.; Akpa O.; Sarfo F. S.; Akpalu A.; Jenkins C.; Lackland D.
    Background-—Little is known about the relationship between echocardiographic abnormalities and outcome among patients with acute stroke. We investigated the pattern and association of baseline echocardiographic variables with 1-month disability and mortality among patients with stroke in the SIREN (Stroke Investigative Research and Education Network) study. Methods and Results-—We enrolled and followed up consecutive 1020 adult patients with acute stroke with baseline transthoracic echocardiography from west Africa. To explore the relationship between echocardiographic variables and 1-month disability (using modified Rankin scale >3) and fatality, regression models were fitted. Relative risks were computed with 95% CIs. The participants comprised 60% men with a mean age of 59.2_14.6 years. Ischemic stroke was associated with smaller aortic root diameter (30.2 versus 32.5, P=0.018) and septal (16.8 versus 19.1, P<0.001) and posterior wall thickness at systole (18.9 versus 21.5, P=0.004). Over 90% of patients with stroke had abnormal left ventricular (LV) geometry with eccentric hypertrophy predominating (56.1%). Of 13 candidate variables investigated, only baseline abnormal LV geometry (concentric hypertrophy) was weakly associated with 1-month disability (unadjusted relative risk, 1.80; 95% CI, 0.97–5.73). Severe LV systolic dysfunction was significantly associated with increased 1-month mortality (unadjusted relative risk, 3.05; 95% CI, 1.36–6.83). Conclusions-—Nine of 10 patients with acute stroke had abnormal LV geometry and a third had systolic dysfunction. Severe LV systolic dysfunction was significantly associated with 1 month mortality. Larger studies are required to establish the independent effect and unravel predictive accuracy of this association
  • Thumbnail Image
    Item
    Prevalence and prognostic features of ECG abnormalities in acute stroke
    (Elsevier Ltd, 2017) Adeoye A. M.; Ogah O. S.; Ovbiagele B.; Akinyemi R.; Shidali V.; Agyekum F.; Aje A.; Adebayo O.; Akinyemi J. O.; Kolo P.; Appiah L. T.; Iheonye H.; Kelechukwu U.; Ganiyu A.; Olunuga T. O.; Akpa O.; Olagoke O. O.; Sarfo F. S.; Wahab K.; Olowookere S.; Fakunle A.; Akpalu A.; Adebayo P. B.; Nkromah K.; Yaria J.; Ibinaiye P.
    Background: Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke out comes have not been previously characterized in Africans. Objectives: The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study. Methods: We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 h of admission and stroke classified based on brain computed tomography scan or magnetic resonance imaging. Stroke severity at baseline was assessed using the Stroke Levity Scale (SLS), whereas 1-month outcome was assessed using the modified Rankin Scale (mRS). Results: Patients’ mean age was 58.4 13.4 years, 490 were men (55%) and 400 were women (45%), 65.5% had ischemic stroke, and 85.4% had at least 1 ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%; p ¼ 0.002), but more likely to have left ventricular hypertrophy (64.4% vs. 51.4%; p ¼ 0.004). Odds of severe disability or death at 1 month were higher with severe stroke (AOR: 2.25; 95% confidence interval: 1.44 to 3.50), or atrial enlargement (AOR: 1.45; 95% confidence interval: 1.04 to 2.02). Conclusions: About 4 in 5 acute stroke patients in this African cohort had evidence of a baseline ECG abnormality, but presence of any atrial enlargement was the only independent ECG predictor of death or disability