Congestive cardiac failure (CCF) as a cause of fatal stroke and all cause death.

BACKGROUND

Congestive cardiac failure (CCF) has been found to be a clinical risk factor for stroke in patients with non rheumatic atrial fibrillation.

AIMS

To study CCF as a risk factor for stroke deaths and all cause deaths in coronary heart disease (CHD).

METHODS

Case control study from a single cardiologist's practice: 370 deaths, 32 (9%) from stroke; controls of 160 and 370 consecutive patients for stroke deaths and all cause deaths respectively. Multivariate analysis using logistic regression.

RESULTS

A--Stroke deaths. Positive associations for CHD with CCF, hypertension; negative association for CHD without CCF. Patients with CHD and CCF were 7.4 times as likely to die from stroke as patients with CHD without CCF. B--All cause deaths. Positive associations for CHD or cardiomyopathy with CCF, atrial fibrillation, diabetes and hypertension; negative association for CHD without CCF. Patients with CHD and CCF were 6.1 times as likely to die from all causes as patients with CHD without CCF.

CONCLUSIONS

Many stroke deaths in patients with CHD and CCF may be cardioembolic in origin. A randomised controlled trial in such patients is indicated to see if anticoagulants can reduce the incidence of stroke.