Long-Term Outcome in Patients With Acute Ischemic Stroke and Heart Failure

Circ J. 2023 Feb 24;87(3):401-408. doi: 10.1253/circj.CJ-21-0937. Epub 2022 Apr 19.


Background: This study aimed to identify the association between long term functional outcomes and acute ischemic stroke (AIS) in patients with heart failure (HF) in Japan and whether 1-year event risks can be related to these patients.Methods and Results: This was a prospective observational study, and 651 patients registered in the Tokyo Women's Medical University Stroke Registry were classified into the HF and non-HF groups. Functional outcome at 1 year after stroke onset was defined as either good (modified Rankin Scale [mRS] score of 0-2) or poor (mRS score of 3-6). The primary outcome was a composite of major adverse cardiovascular events (MACE), including non-fatal stroke, non-fatal acute coronary syndrome, and vascular death. Patients with HF had a higher poor functional outcome rate at 1 year than those without HF (54.7% vs. 28.2%, P<0.001). Multivariate logistic regression analysis also demonstrated the prevalence of HF was an independent predictor of an mRS score of ≥3 at 1 year after stroke onset (odds ratio, 1.05; 95% confidence interval, 1.00-1.10; P=0.036). Furthermore, patients with HF tended to have a higher risk of MACE and all-cause mortality than those without HF.

Conclusions: AIS patients with HF were associated with poor functional outcome at the 1-year follow up. Further multicenter studies involving a larger number of patients are warranted to verify these results.

Keywords: Acute ischemic stroke; Heart failure; Long-term outcome.

Publication types

  • Observational Study

MeSH terms

  • Brain Ischemia*
  • Female
  • Heart Failure* / complications
  • Humans
  • Ischemic Stroke* / complications
  • Japan
  • Prospective Studies
  • Risk Factors
  • Stroke* / etiology
  • Treatment Outcome