Treatment and Outcomes for Acute Ischemic Stroke in Cardiomyopathy Patients With Heart Failure: A Retrospective Cross-Sectional Study

Cardiomyopathy (CM) is a common cause of heart failure (HF), and those with HF have up to a 3-fold increased risk of stroke. This study aims to examine the incidence of intravascular thrombolysis and endovascular thrombectomy and the functional outcomes in acute ischemic stroke (AIS) patients with CM and HF. International Classification of Diseases-10 codes were used to query the National Inpatient Sample database for patients with AIS and concurrent CM and HF from 2016 to 2019. Incidence of reperfusion therapy, medical complications, discharge disposition, length of hospital stay, and mortality between patients with and without CM and HF were compared using propensity score matching and multivariable logistic regression analysis. Of 2,939,160 patients identified with AIS, 80,915 (2.8%) had concomitant diagnoses of CM and HF. Patients in this population had more severe strokes (25.9% vs 19.6%, P < 0.001) and received endovascular thrombectomy at higher rates (8.8% vs 5.6%, P < 0.001) but equivalent rates of intravascular thrombolysis (3.0% vs 2.9%, P = 0.107). Additionally, CM/HF patients were more likely to experience inpatient death (6.6% vs 5.4%, P < 0.001). Despite this, those who survived were statistically more likely to have a favorable discharge disposition (45.7% vs 43.9%, P < 0.001). Although CM and HF patients are more likely to experience complications, prolonged length of stay, and inpatient death, those who survive have higher rates of favorable discharge disposition. These results suggest that stroke intervention is safe and efficacious in patients with CM and HF.