Heart failure (HF) increases the risk of
ischemic stroke. Data regarding the incidence and predictors of
ischemic stroke during hospitalization for HF are limited. The study population of this retrospective cohort study consisted of patients with congestive HF, consecutively admitted to our center from October 2010 to April 2014. We excluded patients complicated with acute
myocardial infarction,
infective endocarditis, and
takotsubo cardiomyopathy. We also excluded those with dialysis or mechanical circulatory support. We investigated the incidence of
ischemic stroke during hospitalization for HF. Thereafter, we divided the patients without oral
anticoagulants at admission into two groups: patients with
ischemic stroke and those without it, and explored the predictors of
ischemic stroke. A total of 558 patients (287 without
atrial fibrillation (AF), 271 with AF) were enrolled. The mean age was 76.8 ± 12.3 years, and 244 patients (44 %) were female. The mean left-ventricular ejection fraction was 47.4 %. Oral
anticoagulants were prescribed in 147 patients (8 without AF, 139 with AF). During hospitalization (median length 18 days), symptomatic
ischemic stroke (excluding
catheter-related) occurred in 15 patients (2.7 % of the total, 8 without AF, 7 with AF). Predictors significantly associated with increased risk of
ischemic stroke in patients without oral
anticoagulants were as follows; short-term increases in blood
urea nitrogen after admission (at day 3; odds ratio (per 1 md/dl): 1.06, 95 % confidence interval (CI) 1.01-1.11, p = 0.02, and at day 7; odds ratio: 1.03, 95 % CI 1.00-1.07, p = 0.03, respectively), and previous
stroke (odds ratio; 3.33, 95 % CI 1.01-11.00, p = 0.04). The incidence of
ischemic stroke during hospitalization for HF was high, even in patients without AF. Previous
stroke and short-term increases in blood
urea nitrogen was significantly associated with the incidence of
ischemic stroke.