Assessment of the impact of resting heart rate on the risk of major adverse cardiovascular events after ischemic stroke: a retrospective observational study

Ching Heng Lin, Jun Fu Zhang, Ya Wen Kuo, Chang Fu Kuo, Yen Chu Huang, Meng Lee, Jiann Der Lee*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

1 Scopus citations

Abstract

BACKGROUND: Although elevated heart rate is a risk factor for cardiovascular morbidity and mortality in healthy people, the association between resting heart rate and major cardiovascular risk in patients after acute ischemic stroke remains debated. This study evaluated the association between heart rate and major adverse cardiovascular events after ischemic stroke.

METHODS: We conducted a retrospective cohort study analyzing data from the Chang Gung Research Database for 21,655 patients with recent ischemic stroke enrolled between January 1, 2010, and September 30, 2018. Initial in-hospital heart rates were averaged and categorized into 10-beats per minute (bpm) increments. The primary outcome was the composite of hospitalization for recurrent ischemic stroke, myocardial infarction, or all-cause mortality. Secondary outcomes were hospitalization for recurrent ischemic stroke, myocardial infarction, and heart failure. Hazard ratios and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, using the heart rate < 60 bpm subgroup as the reference.

RESULTS: After a median follow-up of 3.2 years, the adjusted hazard ratios for the primary outcome were 1.13 (95% CI: 1.01 to 1.26) for heart rate 60-69 bpm, 1.35 (95% CI: 1.22 to 1.50) for heart rate 70-79 bpm, 1.64 (95% CI: 1.47 to 1.83) for heart rate 80-89 bpm, and 2.08 (95% CI: 1.85 to 2.34) for heart rate ≥ 90 bpm compared with the reference group. Heart rate ≥ 70 bpm was associated with increased risk of all secondary outcomes compared with the reference group except heart failure. CONCLUSIONS: Heart rate is a simple measurement with important prognostic implications. In patients with ischemic stroke, initial in-hospital heart rate was associated with major adverse cardiovascular events.

Original languageEnglish
Article number267
Pages (from-to)267
JournalBMC Neurology
Volume24
Issue number1
DOIs
StatePublished - 31 07 2024

Bibliographical note

© 2024. The Author(s).

Keywords

  • Heart Disease Risk Factors
  • Heart Rate
  • Ischemic Stroke
  • Myocardial Infarction/epidemiology
  • Heart Rate/physiology
  • Ischemic Stroke/physiopathology
  • Humans
  • Middle Aged
  • Risk Factors
  • Cardiovascular Diseases/epidemiology
  • Male
  • Heart Failure/physiopathology
  • Aged, 80 and over
  • Female
  • Retrospective Studies
  • Aged

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