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Updated: Sep 28, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Tachycardia is associated with mortality and functional outcome after thrombectomy for acute ischemic stroke
Penina Krieger1, Amanda Zhao1, Leah Croll2
1NYU Grossman School of Medicine, 530 1(st) Ave, New York, NY 10016, United States.
Insights
Tachycardia, or a fast heart rate, is linked to higher mortality in patients undergoing thrombectomy for acute ischemic stroke. Further research is needed to explore if this risk can be modified.
Area of Science:
- Cardiology
- Neurology
- Critical Care Medicine
Background:
- The prognostic implications of cardiac function post-thrombectomy for acute ischemic stroke remain unclear.
- Understanding cardiac risk factors is crucial for improving outcomes in stroke patients.
Purpose of the Study:
- To investigate the association between cardiac function, specifically heart rate, and in-hospital mortality.
- To identify cardiac parameters that predict mortality in patients undergoing mechanical thrombectomy.
Main Methods:
- A retrospective analysis of 248 patients who underwent thrombectomy for acute ischemic stroke.
- Statistical analysis included Welch's t-test and logistic regression, adjusting for age, NIHSS, and ASPECTS scores.
- Cardiac function metrics, including initial and maximum heart rate, and presence of NSTEMI/STEMI were assessed.
Main Results:
- Mortality rate was 16.5% (41 out of 248 patients).
- Higher initial and maximum heart rates were significantly associated with increased mortality (p < 0.001).
- The presence of NSTEMI/STEMI was also a strong predictor of mortality (OR 3.76, p = 0.002).
Conclusions:
- Tachycardia is a significant independent predictor of mortality in patients undergoing thrombectomy for acute ischemic stroke.
- The findings suggest a link between cardiac dysfunction and adverse outcomes after stroke intervention.
- Further studies are warranted to explore potential therapeutic strategies to mitigate the risk associated with tachycardia.
Background:
The relationship between cardiac function and mortality after thrombectomy for acute ischemic stroke is not well elucidated.
Methods:
We analyzed the relationship between cardiac function and mortality prior to discharge in a cohort of patients who underwent thrombectomy for acute ischemic stroke at two large medical centers in New York City between December 2018 and November 2020. All analyses were performed using Welch's two sample t-test and logistic regression accounting for age, initial NIHSS and post-procedure ASPECTS score, where OR is for each unit increase in the respective variables.
Results:
Of 248 patients, 41 (16.5%) died prior to discharge. Mortality was significantly associated with higher initial heart rate (HR; 89 ± 19 bpm vs 80 ± 18 bpm, p = 0.004) and higher maximum HR over entire admission (137 ± 26 bpm vs 114 ± 25 bpm, p < 0.001). Mortality was also associated with presence of NSTEMI/STEMI (63% vs 29%, p < 0.001). When age, initial NIHSS score, and post-procedure ASPECTS score were included in multivariate analysis, there was still a significant relationship between mortality and initial HR (OR 1.03, 95% CI 1.01- 1.05, p = 0.02), highest HR over the entire admission (OR 1.03, 95% CI 1.02-1.05, p < 0.001), and presence of NSTEMI/STEMI (OR 3.76, 95% CI 1.66-8.87, p = 0.002).
Conclusions:
Tachycardia is associated with mortality in patients who undergo thrombectomy. Further investigation is needed to determine whether this risk is modifiable.
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