Usefulness of upright T wave in lead aVR for predicting short-term prognosis of patients with ischemic stroke

Background: Upright T wave in lead aVR (TaVR) has recently been reported to be associated with cardiovascular death and mortality in general population and in patients with prior cardiovascular disease (CVD). However, the evidence for the predictive ability of TaVR in patients with ischemic stroke (...

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Autores principales:	Hong-Jie Yang, Xin Liu, Chuan Qu, Shao-Bo Shi, Bo Yang
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2018
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/2eaf4a4610324ee2b921d0c0bc6eb360
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spelling	oai:doaj.org-article:2eaf4a4610324ee2b921d0c0bc6eb3602021-12-02T17:30:14ZUsefulness of upright T wave in lead aVR for predicting short-term prognosis of patients with ischemic stroke2095-882X10.1016/j.cdtm.2018.01.004https://doaj.org/article/2eaf4a4610324ee2b921d0c0bc6eb3602018-09-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095882X1730107Xhttps://doaj.org/toc/2095-882XBackground: Upright T wave in lead aVR (TaVR) has recently been reported to be associated with cardiovascular death and mortality in general population and in patients with prior cardiovascular disease (CVD). However, the evidence for the predictive ability of TaVR in patients with ischemic stroke (IS) is lacking. Methods: A total of 625 consecutive patients with IS (mean age: 66 ± 12 years; 379 male) were enrolled in this study between January 2013 and December 2014. Patients were divided into upright TaVR (≥0 mV; n = 201) and negative TaVR (<0 mV; n = 424) groups. All patients were evaluated with respect to clinical features and in-hospital clinical results. Results: Overall, the prevalence of upright TaVR was 32.2% at baseline. Patients with an upright TaVR were older, had a higher percentage of CVD and hypertension, higher level of MB isoenzyme of creatine kinase (CKMB), faster heart rate, higher rate of QT prolongation > 450 ms, higher rate of negative T in lead II, higher rate of negative T in lead V6, higher rate of ST depression, and longer QTc duration. During the mean follow-up period of 20.0 ± 5.8 months, 29 (4.6%) patients experienced all-cause death and 12 (1.9%) patients experienced cardiovascular death, the primary end point. Concomitantly, 94 (15%) patients experienced recurrence of IS, the secondary end point. After adjusting for clinical covariates, upright TaVR was independently associated with all-cause death [hazard ratio (HR): 2.88, 95% confidence intervals (CI): 1.07–7.73], cardiovascular death (HR: 3.04, 95% CI: 1.07–8.64), and IS recurrence (HR: 1.86, 95% CI: 1.08–3.20). Conclusions: Upright TaVR in patients with IS is associated with increased mortality and recurrence of IS. Keywords: T wave in lead aVR, Ischemic stroke, PrognosisHong-Jie YangXin LiuChuan QuShao-Bo ShiBo YangKeAi Communications Co., Ltd.articleMedicine (General)R5-920ENChronic Diseases and Translational Medicine, Vol 4, Iss 3, Pp 192-198 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Hong-Jie Yang Xin Liu Chuan Qu Shao-Bo Shi Bo Yang Usefulness of upright T wave in lead aVR for predicting short-term prognosis of patients with ischemic stroke
description	Background: Upright T wave in lead aVR (TaVR) has recently been reported to be associated with cardiovascular death and mortality in general population and in patients with prior cardiovascular disease (CVD). However, the evidence for the predictive ability of TaVR in patients with ischemic stroke (IS) is lacking. Methods: A total of 625 consecutive patients with IS (mean age: 66 ± 12 years; 379 male) were enrolled in this study between January 2013 and December 2014. Patients were divided into upright TaVR (≥0 mV; n = 201) and negative TaVR (<0 mV; n = 424) groups. All patients were evaluated with respect to clinical features and in-hospital clinical results. Results: Overall, the prevalence of upright TaVR was 32.2% at baseline. Patients with an upright TaVR were older, had a higher percentage of CVD and hypertension, higher level of MB isoenzyme of creatine kinase (CKMB), faster heart rate, higher rate of QT prolongation > 450 ms, higher rate of negative T in lead II, higher rate of negative T in lead V6, higher rate of ST depression, and longer QTc duration. During the mean follow-up period of 20.0 ± 5.8 months, 29 (4.6%) patients experienced all-cause death and 12 (1.9%) patients experienced cardiovascular death, the primary end point. Concomitantly, 94 (15%) patients experienced recurrence of IS, the secondary end point. After adjusting for clinical covariates, upright TaVR was independently associated with all-cause death [hazard ratio (HR): 2.88, 95% confidence intervals (CI): 1.07–7.73], cardiovascular death (HR: 3.04, 95% CI: 1.07–8.64), and IS recurrence (HR: 1.86, 95% CI: 1.08–3.20). Conclusions: Upright TaVR in patients with IS is associated with increased mortality and recurrence of IS. Keywords: T wave in lead aVR, Ischemic stroke, Prognosis
format	article
author	Hong-Jie Yang Xin Liu Chuan Qu Shao-Bo Shi Bo Yang
author_facet	Hong-Jie Yang Xin Liu Chuan Qu Shao-Bo Shi Bo Yang
author_sort	Hong-Jie Yang
title	Usefulness of upright T wave in lead aVR for predicting short-term prognosis of patients with ischemic stroke
title_short	Usefulness of upright T wave in lead aVR for predicting short-term prognosis of patients with ischemic stroke
title_full	Usefulness of upright T wave in lead aVR for predicting short-term prognosis of patients with ischemic stroke
title_fullStr	Usefulness of upright T wave in lead aVR for predicting short-term prognosis of patients with ischemic stroke
title_full_unstemmed	Usefulness of upright T wave in lead aVR for predicting short-term prognosis of patients with ischemic stroke
title_sort	usefulness of upright t wave in lead avr for predicting short-term prognosis of patients with ischemic stroke
publisher	KeAi Communications Co., Ltd.
publishDate	2018
url	https://doaj.org/article/2eaf4a4610324ee2b921d0c0bc6eb360
work_keys_str_mv	AT hongjieyang usefulnessofuprighttwaveinleadavrforpredictingshorttermprognosisofpatientswithischemicstroke AT xinliu usefulnessofuprighttwaveinleadavrforpredictingshorttermprognosisofpatientswithischemicstroke AT chuanqu usefulnessofuprighttwaveinleadavrforpredictingshorttermprognosisofpatientswithischemicstroke AT shaoboshi usefulnessofuprighttwaveinleadavrforpredictingshorttermprognosisofpatientswithischemicstroke AT boyang usefulnessofuprighttwaveinleadavrforpredictingshorttermprognosisofpatientswithischemicstroke
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Usefulness of upright T wave in lead aVR for predicting short-term prognosis of patients with ischemic stroke

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