Ya-Wen Kuo1, Meng Lee2,3, Yen-Chu Huang2,3, Jiann-Der Lee4,5. 1. Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Taiwan. 2. Department of Neurology, Chang Gung Memorial Hospital, Chiayi, Taiwan. 3. College of Medicine, Chang Gung University, Taoyuan, Taiwan. 4. Department of Neurology, Chang Gung Memorial Hospital, Chiayi, Taiwan. jdlee540908@gmail.com. 5. College of Medicine, Chang Gung University, Taoyuan, Taiwan. jdlee540908@gmail.com.
Abstract
BACKGROUND: Increased heart rate (HR) has been associated with stroke risk and outcomes. MATERIAL AND METHODS: We analyzed 1,420 patients from a hospital-based stroke registry with acute ischemic stroke (AIS). Mean initial in-hospital HR and the coefficient of variation of HR (HR-CV) were derived from the values recorded during the first 3 days of hospitalization. The study outcome was the 3-month functional outcome. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using multivariable logistic regression analysis. RESULTS: A higher mean HR level was significantly and continuously associated with a higher probability of unfavorable functional outcomes. Compared with the reference group (mean HR < 70 beats per minute), the multivariate-adjusted OR for an unfavorable outcome was 1.81 (95% CI, 1.25-2.61) for a mean HR ≥ 70 and < 80 beats per minute, 2.52 (95% CI, 1.66 - 3.52) for a mean HR ≥ 80 and < 90 beats per minute, and 3.88 (95% CI, 2.20-6.85) for mean HR ≥ 90 beats per minute. For stroke patients with a history of hypertension, the multivariate-adjusted OR for patients with a HR-CV ≥ 0.12 (versus patients with a HR-CV < 0.08 as a reference) was 1.73 (95% CI, 1.11-2.70) for an unfavorable outcome. CONCLUSIONS: Our results indicated that a high initial in-hospital HR was significantly associated with unfavorable 3-month functional outcomes in patients with AIS. In addition, stroke patients with a HR-CV ≥ 0.12 also had unfavorable outcomes compared with those with a HR-CV < 0.08 if they had a history of hypertension.
BACKGROUND: Increased heart rate (HR) has been associated with stroke risk and outcomes. MATERIAL AND METHODS: We analyzed 1,420 patients from a hospital-based stroke registry with acute ischemic stroke (AIS). Mean initial in-hospital HR and the coefficient of variation of HR (HR-CV) were derived from the values recorded during the first 3 days of hospitalization. The study outcome was the 3-month functional outcome. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using multivariable logistic regression analysis. RESULTS: A higher mean HR level was significantly and continuously associated with a higher probability of unfavorable functional outcomes. Compared with the reference group (mean HR < 70 beats per minute), the multivariate-adjusted OR for an unfavorable outcome was 1.81 (95% CI, 1.25-2.61) for a mean HR ≥ 70 and < 80 beats per minute, 2.52 (95% CI, 1.66 - 3.52) for a mean HR ≥ 80 and < 90 beats per minute, and 3.88 (95% CI, 2.20-6.85) for mean HR ≥ 90 beats per minute. For strokepatients with a history of hypertension, the multivariate-adjusted OR for patients with a HR-CV ≥ 0.12 (versus patients with a HR-CV < 0.08 as a reference) was 1.73 (95% CI, 1.11-2.70) for an unfavorable outcome. CONCLUSIONS: Our results indicated that a high initial in-hospital HR was significantly associated with unfavorable 3-month functional outcomes in patients with AIS. In addition, strokepatients with a HR-CV ≥ 0.12 also had unfavorable outcomes compared with those with a HR-CV < 0.08 if they had a history of hypertension.
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