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Published on: December 19, 2025

Cardiac Events After Mechanical Thrombectomy in Acute Ischemic Stroke: A Nation-Wide Cohort Study

Nicolaj Grønbæk Laugesen1,2, Jakob Nebeling Hedegaard3,4, David Gaist5

  • 1Cerebrovascular Research Unit Rigshospitalet, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

European Journal of Neurology
|May 28, 2025
PubMed

Insights

Patients undergoing mechanical thrombectomy (MT) for acute ischemic stroke (AIS) have a higher risk of cardiac events post-procedure. This highlights an unrecognized cardiac burden in AIS patients treated with MT.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Mechanical thrombectomy (MT) significantly improves outcomes for large vessel occlusion stroke.
  • Patients undergoing MT often have pre-existing cardiovascular risk factors.
  • The post-procedural cardiac event risk in MT patients compared to other acute ischemic stroke (AIS) patients is not well-defined.

Purpose of the Study:

  • To investigate the risk of cardiac events in AIS patients treated with MT compared to those receiving other reperfusion therapies or no treatment.
  • To identify the burden of cardiac disease in AIS patients undergoing MT.

Main Methods:

  • A registry-based cohort study included all AIS hospitalizations in Denmark (2014-2021).
  • Patients were categorized by reperfusion treatment: MT (with or without IVT), IVT alone, or no reperfusion treatment (NRT).
  • Cardiac events (ischemic heart disease, heart failure, cardiac death) within 6 months were analyzed using inverse probability treatment weighting (IPTW).

Main Results:

  • Among 76,092 AIS patients, 4.4% received MT.
  • MT patients had a higher risk of cardiac events compared to IVT (HRR 1.42) and NRT (HRR 1.35) after IPTW.
  • Cardiac events occurred in 9.6% of MT patients versus 5% in other AIS patients within 6 months.

Conclusions:

  • AIS patients treated with MT face a significantly higher risk of cardiac events within 6 months post-procedure.
  • This study reveals an unrecognized burden of cardiac disease in AIS patients undergoing MT.
  • Further research and risk stratification for cardiac events in MT patients are warranted.
Abstract

Keywords:
AIScardiac eventscerebrovascular disordersheart disease after strokereperfusion treatmentstrokestroke‐heart syndromethrombectomy

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