Electrocardiogram markers predicting ischemic stroke after acute coronary syndrome

Area of Science:

• Cardiology
• Neurology
• Medical Diagnostics

Background:

• Patients with coronary artery disease (CAD) face a higher risk of ischemic stroke (IS).
• Identifying specific electrocardiogram (ECG) markers associated with IS risk in acute coronary syndrome (ACS) patients is crucial for risk stratification and prevention.

Purpose of the Study:

• To screen for significant ECG features that predict the risk of IS in patients treated for ACS.
• To identify specific ECG patterns indicative of increased IS risk post-ACS.

Main Methods:

• A retrospective registry study analyzed 7760 ACS patients with follow-up for incident IS.
• ECGs were analyzed using the Marquette™ 12SL™ ECG Analysis Program.
• Cox regression and subdistribution hazard (SDH) analyses were employed to identify significant ECG predictors after adjusting for relevant covariates.

Main Results:

• Among 7760 patients, 6.3% experienced IS during follow-up.
• Key predictors of IS included premature ventricular complexes (PVCs) or aberrantly conducted complexes in atrial fibrillation/flutter (AF/AFL), left ventricular hypertrophy (LVH), S wave amplitude in lead V4, and negative P wave peak time in lead V2.
• T wave amplitude in lead V6 and T wave duration in lead aVL showed an inverse association with IS risk.

Conclusions:

• ECG markers indicating left ventricular (LV) dysfunction, LVH, and atriopathy are associated with IS risk following ACS.
• These findings highlight the potential of ECG analysis for identifying ACS patients at higher risk of stroke, though external validation is necessary.