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. 2025 Mar 14:16:1551427.
doi: 10.3389/fneur.2025.1551427. eCollection 2025.

Predictive value of heart rate for prognosis in patients with cerebral infarction without atrial fibrillation comorbidity analyzed according to the MIMIC-IV database

Xinrou Song  1 , Luwen Zhu  2
Affiliations

Predictive value of heart rate for prognosis in patients with cerebral infarction without atrial fibrillation comorbidity analyzed according to the MIMIC-IV database

Xinrou Song et al. Front Neurol. .

Abstract

Objective: This study focused on the relationship between heart rate and the likelihood of death within 28 days in patients with cerebral infarction without the comorbidity of atrial fibrillation, using patient data extracted from the MIMIC-IV database.

Method: This study involved a retrospective analysis of clinical data from 1,643 individuals with cerebral infarction who were admitted to the ICU. To investigate the role of heart rate in determining patient survival, we applied a variety of statistical techniques such as Cox regression models, survival analysis using Kaplan-Meier plots, and spline-based models. In addition, we performed analyses by patient subgroups to identify any potential variables that could influence the association between HR and 28-day mortality.

Result: In univariate and multivariate analyses, elevated heart rate was strongly associated with higher 28-day mortality, even after adjusting for confounders such as age, sex, comorbidities, and clinical scores.(HR:1.01, 95%,CI:1.01 ~ 1.02, p = 0.019) Kaplan-Meier survival analysis showed that patients with heart rate > 90 beats/min had a significantly lower probability of survival. Restricted cubic spline (RCS) analysis confirmed a nonlinear relationship between heart rate and mortality. Subgroup analyses demonstrated an interaction between heart rate and factors such as hypertension and mechanical ventilation status.

Conclusion: This study highlights the prognostic significance of heart rate as an independent predictor of 28-day mortality in patients with cerebral infarction who do not have atrial fibrillation.

Keywords: MIMIC-IV database; cerebral infarction; heart rate; predictive modeling; prognosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow-diagram illustrating patient inclusion in the study.
Figure 2
Figure 2
Kaplan–Meier survival curves: effect of heart rate grouping on the probability of 28-day survival in patients with cerebral infarction.
Figure 3
Figure 3
Restricted Cubic Spline (RCS) Curves Analyzing the Relationship Between Heart Rate and Risk of Death. This figure shows the overall and nonlinear relationship between heart rate and the risk ratio (HR) of death. The solid red line indicates the risk ratio fitted to the RCS model, and the shaded area indicates the 95% confidence interval. The dashed line indicates the reference line for HR = 1.
Figure 4
Figure 4
Forest plot showing hazard ratios (HR) and 95% confidence intervals (CI) for the association between heart rate on the probability of 28-day survival in patients with cerebral infarction, with the dotted line indicating the null (HR = 1).
See this image and copyright information in PMC

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