Key result
Systolic dysfunction in acute ischaemic stroke is linked to ~97% higher 2-year readmission or death.
Why the study?
Systolic dysfunction, diastolic dysfunction, and clinically overt heart failure frequently occur after acute ischaemic stroke, but their distinct prognostic associations with readmission and death remained to be clarified.
Does the presence of systolic dysfunction, diastolic dysfunction, or clinically overt heart failure increase the risk of mortality or hospital readmission in adults with acute ischaemic stroke?
Cohort (n=554)
No
Does the presence of systolic dysfunction, diastolic dysfunction, or clinically overt heart failure increase the risk of mortality or hospital readmission in adults with acute ischaemic stroke?
Systolic dysfunction and clinically overt heart failure identified in the acute phase of ischemic stroke are independent predictors of long-term mortality and hospital readmission.
Systolic dysfunction and overt HF at ischaemic stroke independently signal higher readmission/death risk; extends cardiac phenotyping observations but leaves open targeted intervention trials.
Background: Systolic dysfunction, diastolic dysfunction, and clinically overt heart failure are frequently encountered after acute ischaemic stroke. We investigated whether these cardiac phenotypes, considered as distinct entities, are associated with readmission and death within two years after stroke in the prospective SICFAIL cohort. Methods: Adults with acute ischaemic stroke were consecutively enrolled between 01/2014 and 02/2017. Cardiac function was assessed at baseline, and patients were followed annually by mail or telephone. The primary endpoint was the composite of all-cause readmission or death. Secondary analyses considered individual endpoints and cardiovascular readmissions. Associations were estimated using multivariable Cox proportional hazards models. Results: Of 696 enrolled patients, 644 (92.5%) had interpretable echocardiographic data. During two-year follow-up, 206 of 554 patients (37.1%) with complete outcome information were rehospitalised, and 63 of 577 patients (11.4%) with available vital status data died. After adjustment, systolic dysfunction and clinically overt heart failure were independently associated with the composite endpoint (systolic dysfunction: hazard ratio [HR] 1.97 (95% confidence interval [CI], 1.34-2.91); clinically overt heart failure: HR 1.62, 95% CI 1.02-2.58). Systolic dysfunction also predicted cardiovascular readmissions (HR 2.27, 95% CI 1.22-4.21). Diastolic dysfunction was not associated with adverse outcomes. Conclusion: In this cohort, systolic dysfunction and clinically overt heart failure at the time of ischaemic stroke independently predicted the composite of readmission or death over the subsequent two years, whereas isolated diastolic dysfunction was not prognostically informative. Routine echocardiographic assessment after stroke may therefore help identify patients who would benefit from intensified cardiac follow‑up and secondary prevention.
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Ungethüm et al. (2026) conducted a cohort in Acute ischaemic stroke (n=554). Systolic dysfunction vs. Absence of systolic dysfunction was evaluated on Composite of all-cause readmission or all-cause mortality (HR 1.97, 95% CI 1.34-2.91). Systolic dysfunction and clinically overt heart failure present at the time of an acute ischaemic stroke independently predicted a higher risk of all-cause readmission or death over 2 years (HR 1.97 and HR 1.62, respectively).
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