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Heart rate implicated in death among acute stroke patients with atrial fibrillation

12 Dec 2019

The mean heart rate during acute stroke period factors in mortality but not stroke recurrence in patients with atrial fibrillation (AF) hospitalized for acute ischaemic stroke, a study has found. Heart rate variability has no effect on both outcomes.

Researchers used data from multicentre prospective stroke registry database and identified 3,622 ischaemic stroke patients (mean age, 74 years) who had AF and were hospitalized within 48 hours of stroke onset. They collected heart rate information in the acute stroke period, which was categorized as early (within 24 hours of hospitalization; n=2,046) and late (72 hours to 7 days from onset; n=1,576) stages.

In the entire cohort, 102 patients (5.0 percent) had a stroke recurrence and 440 (21.5 percent) died during the first year after stroke.

In the early acute stroke stage analysis, mean heart rate showed a statistically significant nonlinear J-shaped association with mortality (p<0.04 for quadratic and overall effect) but not with stroke recurrence (p>0.1 for quadratic and overall effect). Similar associations were observed in the late acute stroke stage analysis.

The nonlinear and overall effects of the coefficients of variation of heart rate were not significant for mortality and stroke recurrence.

According to the researchers, the findings can be partially explained by the knowledge that the increased risk of death in patients with elevated heart rates and in those with the lowest extreme of mean heart rate may be attributed to decreased heart function.

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Most Read Articles
29 Mar 2020
Targeting a low-density lipoprotein cholesterol level <70 mg/dL following an ischaemic stroke of atherosclerotic origin helps to avoid one in four subsequent major vascular events without increasing the risk of intracranial haemorrhage over about 5 years of follow-up, according to data from the Treat Stroke to Target trial.
Pearl Toh, 12 Sep 2020
Early initiation of rhythm-control therapy led to a significantly reduced risk of major adverse cardiovascular (CV) outcomes compared with usual care (typically rate control) in patients with newly diagnosed atrial fibrillation (AF) at risk of stroke, reveals the EAST-AFNET 4* trial presented at ESC 2020.
Audrey Abella, 16 Sep 2020
The final results of EVAPORATE* reinforce the plaque-regressing potential of icosapent ethyl (IPE) in patients on statins for elevated triglycerides.
01 Feb 2020
High-intensity statin therapy appears to be seeing increased use in patients with acute coronary syndrome and leads to better lipid control, according to a recent Thailand study.