Corrected QTc interval combined with troponin value and mortality in acute ischemic stroke

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Ji-Sung Lee¹  Soo-Young Kim²  Dong-Wha Kang²  Jung-Hee Han²  Sun U. Kwon²  Jong S. Kim³  Sung-Ho Ahn⁴  Min-Gyu Park⁴  Kyung-Pil Park⁴  Mi-sook Yun⁵  Sang-Hyun Lee⁶ 

[1] Clinical Research Center, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea;Department of Neurology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea;Department of Neurology, Gangneung Asan Hospital,, University of Ulsan, Gangneung, Republic of Korea;Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Republic of Korea;Division of Biostatistics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Republic of Korea;Division of Cardiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Republic of Korea;

关键词: ischemic stroke;    electrocardiography;    troponin;    QTc interval;    mortality;   

DOI  :  10.3389/fcvm.2023.1253871

 received in 2023-07-26, accepted in 2023-09-08,  发布年份 2023

来源: Frontiers

【 摘 要 】

Background and PurposeCardiac biomarkers including, elevated troponin (ET) and prolonged heart rate-corrected QT (PQTc) interval on electrocardiography are known to frequent and have a prognostic significance in patients with acute ischemic stroke (AIS). However, it is still challenging to practically apply the results for appropriate risk stratification. This study evaluate whether combining ET and PQTc interval can better assess the long-term prognosis in AIS patients.MethodsIn this prospectively registered observational study between May 2007 and December 2011, ET was defined as serum troponin-I ≥ 0.04 ng/ml and PQTc interval was defined as the highest tertile of sex-specific QTc interval (men ≥ 469 ms or women ≥ 487 ms).ResultsAmong the 1,668 patients [1018 (61.0%) men; mean age 66.0 ± 12.4 years], patients were stratified into four groups according to the combination of ET and PQTc intervals. During a median follow-up of 33 months, ET (hazard ratio [HR]: 4.38, 95% confidence interval [CI]: 2.94–6.53) or PQTc interval (HR: 1.53, 95% CI: 1.16–2.01) alone or both (HR: 1.77, 95% CI: 1.16–2.71) was associated with increased all-cause mortality. Furthermore, ET, PQTc interval alone or both was associated with vascular death, whereas only ET alone was associated with non-vascular death. Comorbidity burden, especially atrial fibrillation and congestive heart failure, and stroke severity gradually increased both with troponin value and QTc-interval.ConclusionsIn patients with AIS, combining ET and PQTc interval on ECG enhances risk stratification for long-term mortality while facilitating the discerning ability for the burden of comorbidities and stroke severity.

【 授权许可】

Unknown   
© 2023 Ahn, Lee, Yun, Han, Kim, Lee, Park, Park, Kang, Kim and Kwon.