The highest quartile of QTc interval was associated with a significantly increased risk of all-cause death (HR 1.49) compared to the lowest quartile in patients with acute ischemic stroke.
Cohort (n=1,668)
No
Does a prolonged QTc interval predict long-term all-cause mortality in patients with acute ischemic stroke?
Prolonged QTc interval at admission in patients with acute ischemic stroke is an independent predictor of long-term all-cause mortality, reflecting both cardiac and neurological burden.
Effect estimate: HR 1.49 (95% CI 1.07-2.08)
Absolute Event Rate: 25.5% vs 15.1%
p-value: p=0.04
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.
Ahn et al. (Mon,) conducted a cohort in Acute Ischemic Stroke (n=1,668). Highest quartile of QTc interval (≥479 ms in men, ≥498 ms in women) vs. Lowest quartile of QTc interval was evaluated on All-cause death (HR 1.49, 95% CI 1.07-2.08, p=0.04). The highest quartile of QTc interval was associated with a significantly increased risk of all-cause death (HR 1.49) compared to the lowest quartile in patients with acute ischemic stroke.