Electrocardiographic changes in patients with ischaemic stroke and their prognostic importance

We investigated prognostic importance of electrocardiographic (ECG) changes in ischaemic stroke patients without primary heart disease because of the limited evidence. This study consisted of 162 patients (92 male, age 64 +/- 14 years) with first ischaemic stroke presenting to hospital during 18 months. One-month mortality was analysed by means of ischaemia-like ECG changes, long QT and arrhythmia. Ischaemia-like ECG changes were observed in 79% of stroke patients and long QTc in 26% and arrhythimas in 44%. Early mortality rate was 27% (n = 44). Age, ST-segment change and abnormal U wave were univariate predictors of early mortality (each p < 0.05). In multivariate analysis, age > 65 years (OR = 1.4, p = 0.02) and presence of ST-segment change (OR= 2.6, p = 0.0 1) were only independent predictors. Although sensitivity and specificity of ST-segment change were relatively low to identify patients at risk of death, its negative predictive value was 82%. The ECG changes are frequently seen in selected patients with ischaemic stroke. Regardless of origin, ST-segment change can be a predictor of early mortality.