Parietal Lobe Stroke Carries Risk of Future Fatal Cardiac Events

NEW YORK (Reuters Health) Sept 18 - The first report of a link between parietal lobe stroke and subsequent cardiac death appears in the September issue of Stroke.

The finding comes from investigators with the Northern Manhattan Study, an ongoing population-based study with the objective of determining stroke incidence, stroke risk factors and prognosis in a multiethnic urban population.

Dr. Mitchell S. V. Elkind of Columbia University’s College of Physicians and Surgeons in New York City and colleagues followed 665 patients with a first ischemic stroke, aged 40 or older (mean age 69.7 years) for an adverse cardiac outcome, including nonfatal myocardial infarction and cardiac death as a result of MI, congestive heart failure, or sudden death/arrhythmia.

During a median follow-up of 4.0 years, 44 patients (6.7%) had fatal cardiac events. Of these, fatal MI occurred in 38.6%, fatal congestive heart failure in 18.2%, and sudden death in 43.2%.

A clinical diagnosis of left parietal lobe infarction was associated with cardiac death, with an adjusted hazard ratio (HR) of 4.45. The hazard ratio for cardiac death or MI was 3.30.

When only neuroimaging findings (computed tomography, magnetic resonance imaging or both) were considered in assessing stroke site, left parietal lobe infarction was associated an adjusted HR of 3.37 for cardiac death.

Both left and right parietal lobe infarctions were associated with cardiac death or MI. Left parietal lobe stroke had a slightly stronger association than a right parietal stroke.

The team found no association between frontal, temporal, or insular stroke and fatal cardiac events.

“Our finding that parietal lobe strokes appear to be associated with future risk of cardiac events and death is novel, and thus warrants confirmation in other studies before definite clinical recommendations can be made,” Dr. Elkind told Reuters Health.

“Nonetheless, the findings would suggest that physicians should be attentive to potential increased cardiac risks in these patients, follow them carefully for development of cardiac symptoms, and consider treating them with medications that have cardioprotective effects, such as statins and beta-blockers, when they develop symptoms,” he advised.

Source:

1. Parietal Lobe Stroke Carries Risk of Future Fatal Cardiac Events