Electrocardiographic and troponin T changes in acute ischaemic stroke

• Published in: Journal of internal medicine 2006-06, Vol.259 (6), p.592-597
• Main Authors: FURE, B., BRUUN WYLLER, T., THOMMESSEN, B.
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; Arrhythmias, Cardiac - complications; Biological and medical sciences; Biomarkers - blood; ECG; Electrocardiography; Female; General aspects; Humans; Long QT Syndrome - complications; Male; Medical sciences; Middle Aged; Neurology; Prognosis; Prospective Studies; stroke; Stroke - blood; Stroke - complications; Stroke - physiopathology; Troponin T - blood; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0954-6820; 1365-2796
• DOI: 10.1111/j.1365-2796.2006.01639.x

. Background.  The mechanisms explaining morphological electrocardiogram (ECG) changes and increased troponin T (TnT) in acute stroke are unclear. The aims of the present study were to assess the prevalence of ECG and TnT changes in acute ischaemic stroke, to investigate whether ischaemic‐like ECG changes correlate to a rise in TnT and to examine whether ECG changes and elevated TnT predict a poor short‐time outcome. Methods.  From 2000 to 2002 a total of 279 patients suffering from acute ischaemic stroke were included prospectively in the present study. ECG was carried out at admission and on day 1 in all patients. TnT was analysed at admission and on day 1. Results.  The most frequent ECG changes were: prolonged QTc 36.0%, ST depression 24.5%, atrial fibrillation 19.9% and T wave inversion 17.8%. In logistic regression analyses, ST depression and Q waves were significantly associated with a rise in TnT. TnT was elevated (>0.04 μg L−1) in 26 patients (9.6%). In logistic regression analyses, a rise in TnT was significantly associated with a poor short‐term outcome (modified Rankin scale >3). Conclusion.  ECG changes are prevalent in acute ischaemic stroke. ST depression and Q waves are related to an increase in TnT, suggesting that these ECG changes may indicate coexisting ischaemic heart disease. A rise in TnT predicts a poor outcome. Patients with acute ischaemic stroke should be offered adequate treatment with secondary prevention and preferably a follow‐up with focus on cardiologic as well as neurological aspects.