To explore the effects of onset time of electrocardiogram (ECG) abnormalities at an early stage of acute ischemic stroke on patient prognosis. Cardiac dysfunction after stroke is a challenge for clinicians. This is a retrospective study of patients in the neurology departments of 23 hospitals in Shanghai and Wuhan, China.
The medical records of 351 patients were compared. Chi-square, Kruskal–Wallis, Mann–Whitney U tests, and stratification compared subgroups. Logistic regressions analyzed factors associated with modified Rankin Scale (mRS) score.
ECG abnormalities occurred in 70.1% of patients at an early stage (most were within 48 hours of disease onset) at least once, whereas 45.9% of the patients had ECG abnormalities within 48 hours of onset and at 7 days after onset. The incidence of poor prognosis (mRS >1) was significantly higher in the patients with ECG abnormalities for both time points than that in those with normal ECGs (56.3% versus 32%, odds ratio = 2.166). Most patients demonstrated 1 to 2 ECG abnormalities, and very few patients had 3 or more. Increasing number of ECG abnormalities was mirrored by poorer prognosis. ECG abnormalities occurred within 48 hours and at the seventh day after onset of acute ischemic stroke; the abnormalities that appeared within 48 hours and were still found on the seventh day after onset of the disease were independent predictors of poor patient prognosis.
The incidence of abnormal ECGs was high in the patients with acute ischemic stroke, and the abnormal ECGs could appear at any stage of the disease.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Stroke and Cerebrovascular Diseases
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Predictors of early cardiac morbidity and mortality after ischemic stroke.Stroke. 2007; 38: 2295-2302
- Cerebrogenic cardiac arrhythmias: cortical lateralization and clinical significance.Clin Auton Res. 2006; 16: 6-11
- Acute myocardial and plasma catecholamine changes in experimental stroke.Stroke. 1986; 17: 387-390
- Cardio-protection in acute stroke.Int J Stroke. 2007; 2: 299-301
- The electrocardiogram in stroke: relationship to pathophysiological type and comparison with prior tracings.Stroke. 1979; 10: 253-259
- Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists.Stroke. 2007; 38: 1655-1711
- Electrocardiograms with large, upright T waves and long Q-T intervals.Am Heart J. 1947; 33: 796-806
- A new electrocardiographic pattern observed in cerebrovascular accidents.Circulation. 1954; 9: 719-723
- Electrocardiographic changes in cerebrovascular accidents.Acta Med Scand. 1969; 185: 327-334
- The incidence of ECG abnormalities in acute cerebrovascular accidents.Acta Med Scand. 1974; 195: 45-47
- Electrocardiographic Q-waves as a predictor of mortality in patients with cerebral infarction.Neurology. 2004; 62: 1818-1821
- The insula and cerebrogenic sudden death.Arch Neurol. 2000; 57: 1685-1688
- Age and follow-up time affect the prognostic value of the ECG and conventional cardiovascular risk factors for stroke in adult men.J Epidemiol Community Health. 2007; 61: 704-712
- Outcomes from ischemic stroke subtypes classified by the Oxfordshire Community Stroke Project: a systematic review.Eur J Phys Rehabil Med. 2011; 47: 19-23
- Oxfordshire community stroke project clinical stroke syndrome and appearances of tissue and vascular lesions on pretreatment CT in hyperacute ischemic stroke among the first 510 patients in the Third International Stroke Trial (IST-3).Stroke. 2009; 40: 743-748
- Electrocardiographic T-wave changes underlying acute cardiac and cerebral events.Am J Emerg Med. 2008; 26: 716-720
- The prognostic value of the modified Rankin Scale score for long-term survival after first-ever stroke. Results from the Athens Stroke Registry.Cerebrovasc Dis. 2008; 26: 381-387
- Epidemiological transition of stroke in China: twenty-one-year observational study from the Sino-MONICA-Beijing Project.Stroke. 2008; 39: 1668-1674
- Electrocardiographic changes and myocardial damage in patients with acute cerebrovascular accidents.Stroke. 1977; 8: 448-455
- Prevalence of electrocardiographic ST-T changes during acute ischemic stroke in patients without known ischemic heart disease.Int J Cardiol. 2008; 128: 137-138
- Impact of resting heart rate on mortality, disability and cognitive decline in patients after ischaemic stroke.Eur Heart J. 2012; 33: 2804-2812
- High resting heart rate predicts mortality, disability, and cognitive decline in patients after ischaemic stroke: time for additional selective I(f) channel inhibitor trials?.Eur Heart J. 2012; 33: 2761-2763
- Effect of changing heart rate during treatment of hypertension on incidence of heart failure.Am J Cardiol. 2012; 109: 699-704
Published online: May 01, 2015
Accepted: March 30, 2015
Received in revised form: March 24, 2015
Received: February 9, 2015
The authors declare that they did not receive any grant support.
The authors declare that they have no conflict of interest.
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.