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Updated: Nov 2, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Initial in-hospital heart rate is associated with three-month functional outcomes after acute ischemic stroke
Ya-Wen Kuo1, Meng Lee2,3, Yen-Chu Huang2,3
1Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Taiwan.
Insights
High initial heart rate (HR) in acute ischemic stroke (AIS) patients is linked to poor functional outcomes. Elevated HR variability also predicts worse outcomes in hypertensive AIS patients.
Area of Science:
- Cardiology
- Neurology
- Stroke Medicine
Background:
- Elevated heart rate (HR) is a known risk factor for stroke and can impact patient outcomes.
- Understanding the relationship between initial in-hospital HR and functional recovery is crucial for acute ischemic stroke (AIS) management.
Purpose of the Study:
- To investigate the association between mean initial in-hospital heart rate (HR) and the coefficient of variation of HR (HR-CV) with 3-month functional outcomes in patients with acute ischemic stroke (AIS).
- To determine if HR parameters predict functional outcomes in AIS patients, particularly those with a history of hypertension.
Main Methods:
- Analysis of 1,420 patients from a hospital-based stroke registry with acute ischemic stroke (AIS).
- Calculation of mean initial in-hospital HR and HR-CV from the first 3 days of hospitalization.
- Multivariable logistic regression analysis to estimate odds ratios (ORs) for 3-month functional outcomes.
Main Results:
- A higher mean HR level was significantly associated with an increased probability of unfavorable functional outcomes.
- Multivariate-adjusted OR for unfavorable outcomes increased with higher mean HR categories (≥70 to <80, ≥80 to <90, ≥90 bpm).
- For hypertensive AIS patients, a HR-CV ≥ 0.12 was associated with unfavorable outcomes compared to HR-CV < 0.08 (OR 1.73).
Conclusions:
- High initial in-hospital heart rate is a significant predictor of unfavorable 3-month functional outcomes in AIS patients.
- Elevated HR-CV (≥ 0.12) is associated with unfavorable outcomes in AIS patients with a history of hypertension.
Background:
Increased heart rate (HR) has been associated with stroke risk and outcomes.
Material And Methods:
We analyzed 1,420 patients from a hospital-based stroke registry with acute ischemic stroke (AIS). Mean initial in-hospital HR and the coefficient of variation of HR (HR-CV) were derived from the values recorded during the first 3 days of hospitalization. The study outcome was the 3-month functional outcome. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using multivariable logistic regression analysis.
Results:
A higher mean HR level was significantly and continuously associated with a higher probability of unfavorable functional outcomes. Compared with the reference group (mean HR < 70 beats per minute), the multivariate-adjusted OR for an unfavorable outcome was 1.81 (95% CI, 1.25-2.61) for a mean HR ≥ 70 and < 80 beats per minute, 2.52 (95% CI, 1.66 - 3.52) for a mean HR ≥ 80 and < 90 beats per minute, and 3.88 (95% CI, 2.20-6.85) for mean HR ≥ 90 beats per minute. For stroke patients with a history of hypertension, the multivariate-adjusted OR for patients with a HR-CV ≥ 0.12 (versus patients with a HR-CV < 0.08 as a reference) was 1.73 (95% CI, 1.11-2.70) for an unfavorable outcome.
Conclusions:
Our results indicated that a high initial in-hospital HR was significantly associated with unfavorable 3-month functional outcomes in patients with AIS. In addition, stroke patients with a HR-CV ≥ 0.12 also had unfavorable outcomes compared with those with a HR-CV < 0.08 if they had a history of hypertension.
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