Inpatient Rehabilitation and Major Adverse Cardiovascular Events After Ischemic Stroke: Clinical Implications and Evidence Synthesis

Highlights

• Postacute discharge to inpatient rehabilitation facilities (IRFs) is linked to a significantly lower 1-year incidence of major adverse cardiovascular events (MACE) among acute ischemic stroke (AIS) survivors, compared with discharge to home or skilled nursing facilities (SNFs).
• The protective association of IRF discharge against MACE is more pronounced in patients younger than 65 years, suggesting age-related differences in benefits of rehabilitation intensity or access.
• Multistate, large-scale cohort evidence supports the postacute care setting as a modifiable system-level target for secondary prevention strategies following AIS.
• Risk factors for post-stroke MACE include functional status on admission, smoking, atrial fibrillation, and facility characteristics, highlighting multidimensional intervention opportunities.