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Long QTc predicts future cardiac death in stroke survivors

K Y K Wong1, R S Mac Walter, D Douglas

  • 1The Cardiovascular Research Group, Department of Clinical Pharmacology and Therapeutics, University of Dundee Medical School, Ninewells Hospital, Dundee, UK. kywong@doctors.org.uk

Heart (British Cardiac Society)
|March 18, 2003
PubMed

Insights

Prolonged QTc interval on ECG, particularly in lead V6, predicts cardiac death in stroke survivors. This finding suggests a need for intensified cardiac risk management beyond standard stroke care.

Area of Science:

  • Cardiology
  • Neurology
  • Electrocardiography

Background:

  • Stroke survivors face elevated risks of mortality, including cardiac causes.
  • The electrocardiogram (ECG) provides valuable cardiac information, but its prognostic utility post-stroke requires further elucidation.

Purpose of the Study:

  • To investigate the hypothesis that the QTc interval from any ECG lead predicts death after stroke.
  • To identify specific ECG leads where a prolonged QTc interval signifies the greatest risk of cardiac death.

Main Methods:

  • Analysis of standard 12-lead ECGs from 404 stroke survivors.
  • One observer, blinded to patient outcomes, performed ECG analysis.
  • Follow-up for up to 6.3 years to record all-cause and cardiac mortality.

Main Results:

  • A prolonged QTc interval in any ECG lead (except aVR) was associated with all-cause mortality.
  • Leads III and V6 showed the highest relative risk for cardiac death (3.1-fold increase).
  • After adjusting for risk factors, a prolonged QTc in lead V6 remained a significant predictor of cardiac death (RR 2.8) and all-cause death (RR 2.9). A QTc > 480 ms in V6 predicted cardiac death within 5 years with 94% specificity.

Conclusions:

  • A prolonged QTc interval in lead V6 is a significant independent predictor of cardiac death in stroke survivors.
  • These findings highlight the need for enhanced cardiac risk assessment and management in stroke survivors with specific ECG findings.
  • Intensified investigations and treatments may be warranted for stroke survivors identified with prolonged QTc intervals, particularly in lead V6.
Abstract

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