QTc interval and QTc dispersion as indicators of short-term outcomes in acute ischemic stroke patients

Abstract

Introduction: Interaction between the central nervous system and the cardiovascular system in acute cerebrovascular events can lead to electrocardiographic changes like ST segment deviation, QT interval prolongation, and T wave changes and affect the outcome. This study was done to assess and compare corrected QT (QTc) interval and corrected QT dispersion (QTcd) as prognostic markers for short-term outcomes of acute ischemic stroke. Patients and methods: Ninety-six patients with acute ischemic stroke were included in the study. QTc interval and QTcd were determined for all patients using an electrocardiogram recorded at the time of admission. The patients were assessed for their outcome during hospitalization and at 3 months. The predictive values of QTc interval and QTcd regarding 3-month mortality were assessed and compared using receiver operating characteristic curves.

Results: Prolonged QTc interval was observed in 14.6% of patients with acute ischemic stroke while prolonged QTcd was observed in 16.7% of patients. For predicting the short-term outcome of acute ischemic stroke, the C-statistic of the QTc interval was 0.702 (p=0.006, 95% CI 0.555 - 0.848) and was statistically significant. The C-statistic of the QTcd was 0.680 (p=0.014, 95% CI 0.544 - 0.815) and was statistically significant. The difference between the C-statistics of QTc interval and QTcd was not statistically significant (p=0.752).

Conclusions: Both QTc interval and QTcd were good predictors of short-term outcomes of acute ischemic stroke. QTc interval was slightly better than QTcd for predicting the short-term outcome of acute ischemic stroke but the difference was not significant.