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ECG markers associated with ischemic stroke at young age - a case-control study.

Jani Pirinen1,2,3, Antti Eranti4, Paul Knekt5

  • 1a Department of Cardiology , Heart and Lung Center, Helsinki University Hospital, University of Helsinki , Helsinki , Finland.

Annals of Medicine
|June 29, 2017
PubMed
Summary

Electrocardiogram (ECG) markers indicating atrial pathology, such as P-wave abnormalities and left ventricular hypertrophy (LVH), are linked to increased ischemic stroke risk in young adults. These ECG findings were particularly associated with cardioembolic and cryptogenic stroke subtypes.

Keywords:
CardioembolismP-wavecase-control studycryptogenic strokeelectrocardiographicembolic strokes of undetermined sourceleft ventricular hypertrophystrokestroke in the young

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Area of Science:

  • Cardiology
  • Neurology
  • Medical Diagnostics

Background:

  • Electrocardiogram (ECG) abnormalities are recognized risk factors for ischemic stroke (IS), particularly the cardioembolic subtype.
  • Markers of left ventricular hypertrophy (LVH) and atrial pathology on ECG, beyond atrial fibrillation, are associated with elevated IS risk.

Purpose of the Study:

  • To investigate the association between specific ECG markers of atrial abnormality and IS in young adults.
  • To identify ECG patterns indicative of increased IS risk in the 15-49 age group.

Main Methods:

  • A case-control study involving 567 IS patients and 1033 controls aged 15-49 years.
  • ECGs were analyzed for P-terminal force (PTF), interatrial blocks (IAB), and LVH.
  • Conditional logistic regression was employed to assess associations.

Main Results:

  • Interatrial blocks (IAB) and P-terminal force (PTF) combined with LVH showed independent association with IS.
  • LVH, abnormal P-wave, PTF, and IAB, along with their combinations with LVH, were linked to the cardioembolic stroke subtype.
  • Abnormal P-wave and IAB were associated with cryptogenic stroke.

Conclusions:

  • ECG patterns reflecting atrial pathology serve as significant markers for increased ischemic stroke risk in young adults.
  • These ECG markers are associated with both cardioembolic and cryptogenic subtypes of IS, highlighting their diagnostic utility.