Resting Heart Rate and In-Hospital Mortality in Acute Ischemic Stroke Patients With and Without Atrial Fibrillation

Qiao Han; Chunyuan Zhang; Shoujiang You; Danni Zheng; Chongke Zhong; Hongli Dong; Xianhui Wang; Shaofang Pei; Yongjun Cao; Chun-Feng Liu

doi:10.1253/circj.CJ-19-0946

Stroke

Resting Heart Rate and In-Hospital Mortality in Acute Ischemic Stroke Patients With and Without Atrial Fibrillation

Qiao Han, Chunyuan Zhang, Shoujiang You, Danni Zheng, Chongke Zhong, Hongli Dong, Xianhui Wang, Shaofang Pei, Yongjun Cao, Chun-Feng Liu

Author information

Qiao Han
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University [China]
Department of Neurology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine [China]
Chunyuan Zhang
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University [China]
Shoujiang You
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University [China]
Danni Zheng
Discipline of Pharmacology, Faculty of Medicine and Health, University of Sydney [Australia]
The George Institute for Global Health, Faculty of Medicine, University of New South Wales [Australia]
Chongke Zhong
Department of Epidemiology, School of Public Health, Medical College of Soochow University [China]
Hongli Dong
Department of Neurology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine [China]
Xianhui Wang
Department of Neurology, Taicang First People’s Hospital [China]
Shaofang Pei
Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University [China]
Yongjun Cao
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University [China]
Institutes of Neuroscience, Soochow University [China]
Chun-Feng Liu
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University [China]
Institutes of Neuroscience, Soochow University [China]

Keywords: Acute ischemic stroke, Atrial fibrillation, In-hospital mortality, Prognosis, Resting heart rate

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Supplementary material

2020 Volume 84 Issue 4 Pages 656-661

DOI https://doi.org/10.1253/circj.CJ-19-0946

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Abstract

Background:The prognostic role of resting heart rate (RHR) on mortality in acute ischemic stroke (AIS) patients including atrial fibrillation (AF) is unclear. This study evaluated the relationship between RHR and in-hospital mortality among all AIS patients with and without AF.

Methods and Results:The study enrolled 3,447 AIS patients from December 2013 to May 2014 across 22 hospitals in Suzhou City. Patients were divided into 2 groups based on median baseline RHR (<76 and ≥76 beats/min). Cox proportional hazard regression models were used to estimate the effects of RHR on all-cause in-hospital mortality. During hospitalization, 124 patients (3.6%) died from all causes. A multivariable model adjusted for potential covariates showed that higher RHR (≥76 beats/min) was associated with an increase in the risk of in-hospital mortality among AIS patients (hazard ratio [HR] 1.63; 95% confidence interval [CI] 1.09–2.45; P=0.018). This relationship was consistent in a subgroup analysis of patients without AF (HR 2.39; 95% CI 1.29–4.45; P=0.006). However, there was no significant association between higher RHR and in-hospital mortality among patients with AF (P=0.654). Similar findings were confirmed in analyses with heart rate as a continuous variable.

Conclusions:Higher RHR at admission was independently associated with in-hospital mortality in AIS patients without AF.

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