{"id":"888df5e9edf2","type":"article","url":"https://hartvaat.nl/2026/05/05/uk-biobank-na-ischemisch-cva-of-tia-is-het-risico-op-hartfalen-groter-dan-dat-op/","title":"UK Biobank: na ischemisch CVA of TIA is het risico op hartfalen groter dan dat op hartinfarct","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts","internist"],"tags":["cerebrovasculair"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag123","source_url":"https://doi.org/10.1093/eschf/xvag123","authors":["Rahul G Muthalaly","Nitesh Nerlekar","Sean Tan","Andrew Lin","Adam J Nelson","Thanh Phan","Henry Ma","Stephen J Nicholls"],"significance":7,"published":"2026-06-29","source_date":"2026-05-05","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hfref-hartfalen-met-verminderde-ejectie/","https://hartvaat.nl/kennis/hartfalen/hfmref-hartfalen-met-matig-verminderde-ejectie/"],"congress":"","summary_en":"Prospective cohort study within UK Biobank (n=405,406, ages 40-69; 45.6% male). Patients with prior heart failure were excluded and stratified by history of ischaemic stroke/TIA. Over 13.7 years of follow-up, 15,565 incident HF events occurred. Stroke survivors had an unadjusted HR of 3.6 (95% CI 3.3-3.8) for HF hospitalisation and adjusted HR of 1.4 (95% CI 1.3-1.5). Notably, the risk of incident HF exceeded the risk of recurrent MI (12.6% vs 5.4%). Stroke survivors who developed HF had lower LVEF and higher LV mass on CMR. Incident HF in this group was associated with aHR 1.8 for mortality. The findings suggest stroke survivors are an underrecognised high-risk population for HF, predominantly with a low-EF phenotype — supporting future preventive HF trials in this group.","created":"2026-07-03T10:33:08Z","updated":"2026-07-03T13:32:02Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Prospectieve cohortstudie binnen UK Biobank (n=405.406, leeftijd 40-69 jaar; 45,6% mannen). Patiënten met voorgeschiedenis van hartfalen werden uitgesloten en gestratificeerd op ischemisch CVA/TIA-historie. Over 13,7 jaar follow-up traden 15.565 nieuwe hartfalen-events op. CVA-overlevenden hadden een ongecorrigeerde HR van 3,6 (95%-BI 3,3-3,8) voor HF-opname en gecorrigeerde HR van 1,4 (95%-BI 1,3-1,5). Opvallend: het risico op nieuwe HF was groter dan op herinfarct (12,6% vs 5,4%). CVA-overlevenden die HF ontwikkelden hadden lagere LVEF en hogere LV-massa op CMR. Incident HF in deze groep was geassocieerd met aHR 1,8 voor mortaliteit. De bevindingen suggereren dat CVA-overlevenden een onderbelichte hoogrisicopopulatie vormen voor HF, met overwegend lage-EF-fenotype — pleidooi voor toekomstige preventieve HF-trials in deze groep.","abstract_original":"INTRODUCTION: To define incident heart failure (HF) risk in ischaemic stroke/transient ischaemic attack (TIA) survivors. The secondary aims were to define the association of HF with all-cause mortality in stroke survivors and to describe their cardiac magnetic resonance (CMR) findings. METHODS: This was a prospective cohort study using the UK Biobank (UKBB) cohort of individuals aged 40 to 69 years old. We excluded individuals with prior HF and stratified them by history of ischaemic stroke/TIA. The main outcome was incident HF as defined by hospital admissions coded for heart failure. Secondary outcomes were all-cause mortality, myocardial infarction, and CMR findings. RESULTS: We included 405 406 individuals (age 56.5 years, 45.6% males). Over 13.7 years, 15 565 individuals experienced incident HF. Stroke survivors had an overall HR of 3.6 [95% confidence interval (CI) 3.3-3.8, P < .0001] for HF hospitalization and an adjusted HR of 1.4 (95% CI 1.3-1.5, P < .0001). The risk of HF hospitalization was greater than the risk of myocardial infarction (12.6% vs 5.4%). Stroke survivors with HF had a lower LVEF and higher LV mass than those without HF. Incident HF in stroke survivors was associated with a HR of 1.8 (95% CI 1.6-1.9, P < .0001) for mortality. CONCLUSION: Incident HF is common in stroke survivors and strongly associates with mortality. The risk of HF varies greatly depending on underlying risk factors. Exploratory analyses suggest that stroke survivors with HF may have a lower ejection fraction phenotype. Future trials of HF preventive therapy in high-risk stroke survivors are warranted."}