A retrospective analysis of the National Inpatient Sample database published in the Cardiology in Review evaluated reperfusion treatment patterns and inpatient outcomes among patients hospitalized with acute ischemic stroke (AIS) and concomitant cardiomyopathy (CM) and heart failure (HF).  International Classification of Diseases-10 codes were used to identify patients admitted between 2016 and 2019.

Among 2,939,160 patients hospitalized with AIS, 80,915 (2.8%) had concurrent CM and HF. Outcomes between patients with and without CM/HF were assessed using propensity score matching and multivariable logistic regression analysis. Study endpoints included use of intravascular thrombolysis and endovascular thrombectomy, inpatient complications, discharge disposition, length of hospital stay, and in-hospital mortality.

Patients with CM/HF experienced more severe strokes compared with those without these conditions (25.9% vs 19.6%; P<0.001). Endovascular thrombectomy was performed more frequently in the CM/HF group (8.8% vs 5.6%; P<0.001), while rates of intravascular thrombolysis were comparable between groups (3.0% vs 2.9%; P=0.107).

In-hospital mortality was higher among patients with CM/HF (6.6% vs 5.4%; P<0.001). Despite greater complications and prolonged hospitalization, survivors with CM/HF were more likely to achieve favorable discharge disposition than patients without CM/HF (45.7% vs 43.9%; P<0.001).

These findings suggest that AIS patients with CM and HF experience higher inpatient risk but may still derive benefit from stroke reperfusion strategies.