An initial in-hospital heart rate of ≥90 bpm was independently associated with a nearly threefold increased risk of all-cause mortality (HR 2.83) compared to <60 bpm in patients with acute ischemic stroke.
Cohort (n=21,655)
Yes
Does higher initial in-hospital heart rate increase all-cause mortality and cardiovascular death in patients with acute ischemic stroke?
High initial in-hospital heart rate is an independent predictor of long-term all-cause mortality and cardiovascular death in patients with acute ischemic stroke.
Hazard Ratio: 2.83 (95% CI 2.46–3.25)
p-value: p=<0.001
AIMS: Increased heart rate has been associated with stroke risk and outcomes. The purpose of this study was to explore the long-term prognostic value of initial in-hospital heart rate in patients with acute ischemic stroke (AIS). METHODS: We analyzed data from 21,655 patients with AIS enrolled (January 2010-September 2018) in the Chang Gung Research Database. Mean initial in-hospital heart rates were averaged and categorized into 10-beat-per-minute (bpm) increments. The primary and secondary outcomes were all-cause mortality and cardiovascular death. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable adjusted Cox proportional hazard models, using the heart rate < 60 bpm subgroup as the reference. RESULTS: The adjusted HRs for all-cause mortality were 1.23 (95% CI 1.08-1.41) for heart rate 60-69 bpm, 1.74 (95% CI 1.53-1.97) for heart rate 70-79 bpm, 2.16 (95% CI 1.89-2.46) for heart rate 80-89 bpm, and 2.83 (95% CI 2.46-3.25) for heart rate ≥ 90 bpm compared with the reference group. Likewise, heart rate ≥ 60 bpm was also associated with an increased risk of cardiovascular death (adjusted HR 1.18 95% CI 0.95-1.46 for heart rate 60-69 bpm, 1.57 95% CI 1.28-1.93 for heart rate 70-79 bpm, 1.98 95% CI 1.60-2.45 for heart rate 80-89 bpm, and 2.36 95% CI 1.89-2.95 for heart rate ≥ 90 bpm). CONCLUSIONS: High initial in-hospital heart rate is an independent predictor of all-cause mortality and cardiovascular death in patients with AIS.
Lee et al. (Sat,) conducted a cohort in Acute ischemic stroke (n=21,655). Initial in-hospital heart rate ≥ 90 bpm vs. Initial in-hospital heart rate < 60 bpm was evaluated on All-cause mortality (HR 2.83, 95% CI 2.46-3.25, p=<0.001). An initial in-hospital heart rate of ≥90 bpm was independently associated with a nearly threefold increased risk of all-cause mortality (HR 2.83) compared to <60 bpm in patients with acute ischemic stroke.