Key result
T-wave changes linked to ~450% higher risk of unfavorable 90-day outcomes post-thrombolysis for acute stroke.
Why the study?
Do electrocardiographic abnormalities predict 90-day functional outcomes in acute ischemic stroke patients treated with intravenous thrombolysis?
Cohort (n=95)
Do electrocardiographic abnormalities predict 90-day functional outcomes in acute ischemic stroke patients treated with intravenous thrombolysis?
T-wave changes on ECG during hospitalization independently predict worse 90-day functional outcomes in acute ischemic stroke patients receiving intravenous thrombolysis.
May flag higher-risk thrombolysis patients; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND/OBJECTIVES: The association between electrocardiographic abnormalities and the outcomes in acute ischemic stroke patients after intravenous thrombolysis remains unclear. We sought to assess the predictive value of electrocardiographic abnormalities in stroke patients after thrombolysis. METHODS: Consecutive acute stroke patients with thrombolysis from Feb 2008 to Jun 2013 were included. Electrocardiographic abnormalities during hospitalization were retrospectively reviewed. Outcomes were 90-day modified Rankin's Score. Multivariate logistic regression was used to analyze the association of electrocardiographic abnormalities with 90-day outcome. RESULTS: From Feb 2008 to Jun 2013, 95 acute stroke patients (median age of 67 and 64.2% male) with electrocardiographic before/after thrombolysis and 90 day modified Rankin's Score were recruited in our study. Increased age (p = 0.027), higher baseline National Institutes of Health Stroke Scale (p < 0.001) and T-wave changes (p = 0.030) were significantly associated with worse functional outcome. T-wave changes (odds ratio 5.54, 95% confidence interval 1.37-22.37, p = 0.016) were independently associated with unfavorable outcome. CONCLUSIONS: T-wave changes can be useful markers to predict the outcome in stroke patients after thrombolysis.
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Wu et al. (2014) conducted a cohort in Acute ischemic stroke treated with intravenous thrombolysis (n=95). T-wave changes vs. Absence of T-wave changes was evaluated on Unfavorable outcome based on 90-day modified Rankin's Score (OR 5.54, 95% CI 1.37-22.37, p=0.016). T-wave changes were independently associated with unfavorable 90-day functional outcomes in acute stroke patients after intravenous thrombolysis (OR 5.54; 95% CI 1.37-22.37; p=0.016).
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