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Prognostic Significance of Prolonged Corrected QT Interval in Acute Ischemic Stroke
Background and Purpose: The aim of this study was to determine the relationship between the heart rate-corrected QT (QTc) interval and the risk of incident long-term mortality in patients with acute ischemic stroke (AIS), considering the impact of sex differences on clinical characteristics, outcome...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720760/ https://www.ncbi.nlm.nih.gov/pubmed/34987464 http://dx.doi.org/10.3389/fneur.2021.759822 |
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author | Ahn, Sung-Ho Lee, Ji-Sung Kim, Young-Hak Yun, Mi-Sook Han, Jung-Hee Kim, Soo-Young Park, Min-Gyu Park, Kyung-Pil Kang, Dong-Wha Kim, Jong S. Kwon, Sun U. |
author_facet | Ahn, Sung-Ho Lee, Ji-Sung Kim, Young-Hak Yun, Mi-Sook Han, Jung-Hee Kim, Soo-Young Park, Min-Gyu Park, Kyung-Pil Kang, Dong-Wha Kim, Jong S. Kwon, Sun U. |
author_sort | Ahn, Sung-Ho |
collection | PubMed |
description | Background and Purpose: The aim of this study was to determine the relationship between the heart rate-corrected QT (QTc) interval and the risk of incident long-term mortality in patients with acute ischemic stroke (AIS), considering the impact of sex differences on clinical characteristics, outcomes, and QTc intervals. Methods: We analyzed prospectively registered data included patients with AIS who visited the emergency room within 24 h of stroke onset and underwent routine cardiac testing, such as measurements of cardiac enzymes and 12-lead ECG. QTc interval was corrected for heart rate using Fridericia's formula and was stratified by sex-specific quartiles. Cox proportional hazards models were used to examine the association between baseline QTc interval and incident all-cause death. Results: A total of 1,668 patients with 1,018 (61.0%) men and mean age 66.0 ± 12.4 years were deemed eligible. Based on the categorized quartiles of the QTc interval, cardiovascular risk profile, and stroke severity increased with prolonged QTc interval, and the risk of long-term mortality increased over a median follow-up of 33 months. Cox proportional hazard model analysis showed that the highest quartile of QTc interval (≥479 msec in men and ≥498 msec in women; hazard ratio [HR]: 1.49, 95% confidence interval [CI]: 1.07–2.08) was associated with all-cause death. Furthermore, dichotomized QTc interval prolongation, defined by the highest septile of the QTc interval (≥501 ms in men and ≥517 m in women: HR: 1.33, 95% CI: 1.00–1.80) was significantly associated with all-cause mortality after adjusting for all clinically relevant variables, such as stroke severity. Conclusions: Prolonged QTc interval was associated with increased risk of long-term mortality, in parallel with the increasing trend of prevalence of cardiovascular risk profiles and stroke severity, across sex differences in AIS patients. |
format | Online Article Text |
id | pubmed-8720760 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87207602022-01-04 Prognostic Significance of Prolonged Corrected QT Interval in Acute Ischemic Stroke Ahn, Sung-Ho Lee, Ji-Sung Kim, Young-Hak Yun, Mi-Sook Han, Jung-Hee Kim, Soo-Young Park, Min-Gyu Park, Kyung-Pil Kang, Dong-Wha Kim, Jong S. Kwon, Sun U. Front Neurol Neurology Background and Purpose: The aim of this study was to determine the relationship between the heart rate-corrected QT (QTc) interval and the risk of incident long-term mortality in patients with acute ischemic stroke (AIS), considering the impact of sex differences on clinical characteristics, outcomes, and QTc intervals. Methods: We analyzed prospectively registered data included patients with AIS who visited the emergency room within 24 h of stroke onset and underwent routine cardiac testing, such as measurements of cardiac enzymes and 12-lead ECG. QTc interval was corrected for heart rate using Fridericia's formula and was stratified by sex-specific quartiles. Cox proportional hazards models were used to examine the association between baseline QTc interval and incident all-cause death. Results: A total of 1,668 patients with 1,018 (61.0%) men and mean age 66.0 ± 12.4 years were deemed eligible. Based on the categorized quartiles of the QTc interval, cardiovascular risk profile, and stroke severity increased with prolonged QTc interval, and the risk of long-term mortality increased over a median follow-up of 33 months. Cox proportional hazard model analysis showed that the highest quartile of QTc interval (≥479 msec in men and ≥498 msec in women; hazard ratio [HR]: 1.49, 95% confidence interval [CI]: 1.07–2.08) was associated with all-cause death. Furthermore, dichotomized QTc interval prolongation, defined by the highest septile of the QTc interval (≥501 ms in men and ≥517 m in women: HR: 1.33, 95% CI: 1.00–1.80) was significantly associated with all-cause mortality after adjusting for all clinically relevant variables, such as stroke severity. Conclusions: Prolonged QTc interval was associated with increased risk of long-term mortality, in parallel with the increasing trend of prevalence of cardiovascular risk profiles and stroke severity, across sex differences in AIS patients. Frontiers Media S.A. 2021-12-20 /pmc/articles/PMC8720760/ /pubmed/34987464 http://dx.doi.org/10.3389/fneur.2021.759822 Text en Copyright © 2021 Ahn, Lee, Kim, Yun, Han, Kim, Park, Park, Kang, Kim and Kwon. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Ahn, Sung-Ho Lee, Ji-Sung Kim, Young-Hak Yun, Mi-Sook Han, Jung-Hee Kim, Soo-Young Park, Min-Gyu Park, Kyung-Pil Kang, Dong-Wha Kim, Jong S. Kwon, Sun U. Prognostic Significance of Prolonged Corrected QT Interval in Acute Ischemic Stroke |
title | Prognostic Significance of Prolonged Corrected QT Interval in Acute Ischemic Stroke |
title_full | Prognostic Significance of Prolonged Corrected QT Interval in Acute Ischemic Stroke |
title_fullStr | Prognostic Significance of Prolonged Corrected QT Interval in Acute Ischemic Stroke |
title_full_unstemmed | Prognostic Significance of Prolonged Corrected QT Interval in Acute Ischemic Stroke |
title_short | Prognostic Significance of Prolonged Corrected QT Interval in Acute Ischemic Stroke |
title_sort | prognostic significance of prolonged corrected qt interval in acute ischemic stroke |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720760/ https://www.ncbi.nlm.nih.gov/pubmed/34987464 http://dx.doi.org/10.3389/fneur.2021.759822 |
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