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March 15, 2026Circulation Reports0 citationsOpen Access

Acute Decompensated Heart Failure Complicated by Ischemic Stroke and Its Association With Hemoglobin Levels

YYYusuke YamazakiYSYasuyuki ShiraishiSKShun Kohsaka

Key Result

Non-anemia was independently associated with a 104% increased risk of early-phase ischemic stroke in patients hospitalized for acute decompensated heart failure.

Key Points

  • The aim is to evaluate how hemoglobin levels relate to the risk of ischemic stroke in patients with acute decompensated heart failure.
  • Analyzed incidence and subtypes of ischemic stroke in acute decompensated heart failure cases.
  • Assessed phase-specific relationships between hemoglobin levels and stroke risk.
  • Conducted a risk assessment of ischemic stroke related to different hemoglobin levels.
  • Identified a notable incidence of ischemic stroke in patients with acute decompensated heart failure.
  • Found a significant association between hemoglobin levels and ischemic stroke risk, varying by stroke subtype.

Study Design

Type

Cohort (n=5,106)

Multicenter

Yes

Structured PICO

Does non-anemia increase the risk of ischemic stroke in patients hospitalized for acute decompensated heart failure?

P
Population
5,106 consecutive patients hospitalized for acute decompensated heart failure (ADHF) across 11 tertiary care hospitals in the Tokyo metropolitan area, Japan. Median age 79.0 years, 58.2% male, median LVEF 45%. Excluded: acute coronary syndrome or age <20 years.
I
Intervention
Non-anemia (hemoglobin ≥13 g/dL in men and ≥12 g/dL in women) at the time of hospitalization
C
Comparator
Anemia (hemoglobin <13 g/dL in men and <12 g/dL in women) at the time of hospitalization
O
Outcome
Incidence of ischemic stroke (IS) after ADHF hospitalization, defined as new focal neurological symptoms lasting ≥24 h, confirmed by CT/MRI and adjudicated by board-certified neurologistshard clinical

Main Result

Effect estimate: sHR 2.04 (95% CI 1.09–3.82)

p-value: p=0.03

Limitations

  • Relatively small number of outcome events
  • Limited long-term effects of hemoglobin trajectories not captured
  • Excluded patients with acute coronary syndrome may limit generalizability
  • Specific IS mechanisms not evaluated due to lack of certain diagnostic data

Abstract

Background: Ischemic stroke (IS) is a serious but underexplored complication of acute decompensated heart failure (ADHF). We assessed the incidence, subtypes, and phase-specific association between hemoglobin and IS risk.

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Cite This Study

Yamazaki et al. (2026) conducted a cohort in Acute Decompensated Heart Failure (n=5,106). Hemoglobin levels analysis vs. Anemia vs Non-anemia was evaluated on Incidence of ischemic stroke after ADHF hospitalization (sHR 2.04, 95% CI 1.09–3.82, p=0.03). Non-anemia was independently associated with a 104% increased risk of early-phase ischemic stroke in patients hospitalized for acute decompensated heart failure.

synapsesocial.com/papers/69b64c67b42794e3e660daebhttps://doi.org/10.1253/circrep.cr-26-0015
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Ischemic Stroke in Acute Decompensated Heart Failure: From the KCHF Registry2021 · 13 citations
  2. 2Heart Failure in Acute Ischemic Stroke2010 · 54 citations
  3. 3Heart Failure Status among Acute Ischemic Stroke Patients: A Hospital-Based Study2022 · 11 citations
  4. 4Ischemic Stroke and Heart Failure: Facts and Numbers. An Update2021 · 34 citations
  5. 5Heart Failure Is Associated With Increased Stroke Severity, In‐Hospital Mortality, Major Adverse Cardiovascular Events, and Complications: Insights From the Chinese Stroke Center Alliance2025 · 4 citations