ArticleJournal of the American Heart Association2025
Persistent Beta-Blocker Therapy Reduces Long-Term Mortality in Patients With Acute Ischemic Stroke With Elevated Heart Rates.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Comment On: "Differential Outcomes of Beta-Blockers According to Heart Rate Following Myocardial Infarction with Reduced Left Ventricular Ejection Fraction".Cardiovascular drugs and therapy · 2026Article
- Efficacy and safety of quadruple therapy versus triple therapy in patients with heart failure with preserved ejection fraction: a propensity score-matched real-world study.Frontiers in cardiovascular medicine · 2026Article
- Brain heart crosstalk after ischemic stroke toward a unified framework for pathophysiology and precision medicine.Frontiers in molecular neuroscience · 2026Review
- Sympathetic overactivation and catecholamine toxicity: mechanisms and therapeutic strategies for neurogenic heart injury following acute ischemic stroke.Frontiers in cardiovascular medicine · 2025Review
- From disruption to remodeling: the evolution and therapeutic prospects of Neuroimmune Regulatory Circuitry after ischemic stroke.Frontiers in immunology · 2025Review
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Authors and funding
37 authors.
Funding
Abstract
backgroundElevated heart rate in patients with acute ischemic stroke is associated with increased risk of mortality. Beta-blocker therapy is well known to reduce heart rate. METHODS AND
resultsThis study was a post hoc analysis of patients with acute ischemic stroke with maximum heart rates ≥100 bpm. Beta-blocker use, assessed on the eighth day after the index stroke, was categorized as persistent or nonpersistent based on usage up to 39 months. The primary outcome was a composite of stroke recurrence, myocardial infarction, and mortality within the first year. Long-term mortality, a secondary outcome, was tracked for up to 10 years. Among 5049 patients (women, 38%; mean age, 68.5 years), 32.1% were prescribed beta blockers by the eighth day after stroke, and 99% had prior beta-blocker use. One-year cumulative incidences of the primary outcome, stroke recurrence, and death were 27.8%, 3.5%, and 25.8%, respectively. Persistent beta-blocker use was associated with a significant reduction in the primary outcome (adjusted hazard ratio [HR], 0.81 [95% CI, 0.68-0.97]) and mortality (adjusted HR, 0.80 [95% CI, 0.69-0.94]) from 2 months to 1 year. Extended analysis of mortality for up to 10 years showed long-term benefits of beta-blocker use. Analyses subdividing patients into persistent users, discontinuers, and never-users suggested higher early mortality risk among discontinuers and potential late survival benefits for persistent users. Subgroup analyses demonstrated greater benefits in patients <75 years, and those with atrial fibrillation, coronary heart disease, and higher mean heart rates.
conclusionsOur study shows that continuation of beta-blocker therapy in patients with acute ischemic stroke with tachycardia significantly reduces long-term mortality.
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