Corrected QTc interval combined with troponin value and mortality in acute ischemic stroke

Area of Science:

• Cardiology
• Neurology
• Clinical Diagnostics

Background:

• Elevated troponin (ET) and prolonged heart rate-corrected QT (PQTc) interval are common in acute ischemic stroke (AIS) and indicate prognosis.
• Current methods for risk stratification using these markers in AIS patients are challenging to apply practically.

Purpose of the Study:

• To evaluate if combining ET and PQTc interval measurements can improve long-term prognosis assessment in AIS patients.
• To determine if combined ET and PQTc interval analysis enhances risk stratification for mortality and aids in evaluating comorbidity burden and stroke severity.

Main Methods:

• A prospective observational study was conducted from May 2007 to December 2011.
• ET was defined as serum troponin-I ≥ 0.04 ng/ml, and PQTc interval was defined as the highest tertile of sex-specific QTc interval (men ≥ 469 ms or women ≥ 487 ms).
• 1,668 AIS patients were stratified into four groups based on the combination of ET and PQTc intervals.

Main Results:

• During a median follow-up of 33 months, ET, PQTc interval alone, or both were associated with increased all-cause mortality.
• ET and PQTc interval (alone or combined) were linked to vascular death, while ET alone was associated with non-vascular death.
• Comorbidity burden (atrial fibrillation, congestive heart failure) and stroke severity increased with higher troponin values and QTc intervals.

Conclusions:

• Combining ET and PQTc interval measurements in AIS patients significantly enhances long-term mortality risk stratification.
• This combined approach improves the ability to discern the burden of comorbidities and the severity of stroke.
• The findings suggest a more refined tool for managing AIS patients and predicting outcomes.