What is the clinical evidence from this study?

Study design: Cohort. Population: Acute Decompensated Heart Failure (n=5106). Intervention: Hemoglobin levels analysis vs. Anemia vs Non-anemia. Primary outcome: Incidence of ischemic stroke after ADHF hospitalization (sHR 2.04, 95% CI 1.09–3.82, p=0.03).

What question did this study set out to answer?

The aim is to evaluate how hemoglobin levels relate to the risk of ischemic stroke in patients with acute decompensated heart failure.

March 15, 2026Open Access

Acute Decompensated Heart Failure Complicated by Ischemic Stroke and Its Association With Hemoglobin Levels

Q: What does this research mean for the field?

Non-anemia is independently associated with a 104% increased risk of early-phase ischemic stroke in patients hospitalized for acute decompensated heart failure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

YYYusuke YamazakiKeio University YSYasuyuki ShiraishiTohoku Institute of Technology SKShun KohsakaKeio University

Key Result

Non-anemia was independently associated with a 104% increased risk of early-phase ischemic stroke in patients hospitalized for acute decompensated heart failure.

Key Points

The aim is to evaluate how hemoglobin levels relate to the risk of ischemic stroke in patients with acute decompensated heart failure.
Analyzed incidence and subtypes of ischemic stroke in acute decompensated heart failure cases.
Assessed phase-specific relationships between hemoglobin levels and stroke risk.
Conducted a risk assessment of ischemic stroke related to different hemoglobin levels.
Identified a notable incidence of ischemic stroke in patients with acute decompensated heart failure.
Found a significant association between hemoglobin levels and ischemic stroke risk, varying by stroke subtype.

Study Design

Type

Cohort (n=5,106)

Multicenter

Yes

Structured PICO

Does non-anemia increase the risk of ischemic stroke in patients hospitalized for acute decompensated heart failure?

Population

5,106 consecutive patients hospitalized for acute decompensated heart failure (ADHF) across 11 tertiary care hospitals in the Tokyo metropolitan area, Japan. Median age 79.0 years, 58.2% male, median LVEF 45%. Excluded: acute coronary syndrome or age <20 years.

Intervention

Non-anemia (hemoglobin ≥13 g/dL in men and ≥12 g/dL in women) at the time of hospitalization

Comparator

Anemia (hemoglobin <13 g/dL in men and <12 g/dL in women) at the time of hospitalization

Outcome

Incidence of ischemic stroke (IS) after ADHF hospitalization, defined as new focal neurological symptoms lasting ≥24 h, confirmed by CT/MRI and adjudicated by board-certified neurologistshard clinical

Main Result

Effect estimate: sHR 2.04 (95% CI 1.09–3.82)

p-value: p=0.03

Limitations

Relatively small number of outcome events
Limited long-term effects of hemoglobin trajectories not captured
Excluded patients with acute coronary syndrome may limit generalizability
Specific IS mechanisms not evaluated due to lack of certain diagnostic data

Abstract

Background: Ischemic stroke (IS) is a serious but underexplored complication of acute decompensated heart failure (ADHF). We assessed the incidence, subtypes, and phase-specific association between hemoglobin and IS risk.

AI에게 질문

Bookmark

View Full Paper