Risk Factors for Acute Heart Failure and Impact on In-Hospital Mortality after Stroke

Area of Science:

• Neurology
• Cardiology
• Critical Care Medicine

Background:

• Stroke patients are at risk of developing cardiac events in the acute phase.
• These cardiac events can be fatal, impacting patient prognosis.
• Understanding and predicting acute heart failure post-stroke is crucial.

Purpose of the Study:

• To investigate the incidence of acute heart failure following stroke onset.
• To identify risk factors associated with acute heart failure after stroke.
• To establish a predictive model for stratifying high-risk patients.

Main Methods:

• A single-center observational study involving 532 stroke patients from January 2013 to December 2014.
• Analysis of baseline characteristics and clinical findings on admission.
• Multivariable logistic regression to assess risk factors and a risk score for poor outcomes.

Main Results:

• 5% (27/532) of stroke patients developed acute heart failure within 7 days of admission.
• Key risk factors identified: atrial fibrillation (OR 5.9), cardiac disease history (OR 3.6), Glasgow Coma Scale ≤ 8 (OR 4.5), and serum albumin < 35 g/L (OR 3.4).
• In-hospital mortality was significantly higher in patients with poststroke heart failure (37% vs. 9.9%), with higher predictive scores correlating with increased mortality.

Conclusions:

• Acute heart failure is a foreseeable and potentially preventable complication in the early stages of stroke.
• Stratifying and closely monitoring high-risk patients can mitigate poor outcomes.
• Early identification and management of post-stroke heart failure are essential for improving survival rates.