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Glob Heart. 2017 Jun;12(2):99-105. doi: 10.1016/j.gheart.2017.01.002. Epub 2017 Mar 14.

Prevalence and Prognostic Features of ECG Abnormalities in Acute Stroke: Findings From the SIREN Study Among Africans.

Author information

1
University of Ibadan, Ibadan, Nigeria.
2
Medical University of South Carolina, Charleston, SC, USA.
3
Federal Medical Centre, Abeokuta, Nigeria.
4
Ahmadu Bello University, Zaria, Nigeria.
5
University of Ghana Medical School, Accra, Ghana.
6
University of Ilorin Teaching Hospital, Ilorin, Nigeria.
7
Komfo Anokye Teaching Hospital, Kumasi, Ghana.
8
Federal Medical Center, Umuahia, Nigeria.
9
Jos University Teaching Hospital, Jos, Nigeria.
10
Ladoke Akintola University of Technology, Ogbomoso, Nigeria.
11
Sacred Heart Hospital, Abeokuta, Nigeria.
12
Federal University Teaching Hospital, Ido-Ekiti, Nigeria.
13
University of Alabama at Birmingham, Birmingham, AL, USA.
14
University of Kentucky at Lexington, Lexington, KY, USA.
15
Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria.
16
Aminu Kano Teaching Hospital, Kano, Nigeria.
17
Delta State University Teaching Hospital, Ogara, Nigeria.
18
Federal Medical Centre, Owo, Nigeria.
19
University of Ibadan, Ibadan, Nigeria. Electronic address: mayowaowolabi@yahoo.com.

Abstract

BACKGROUND:

Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes have not been previously characterized in Africans.

OBJECTIVES:

The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study.

METHODS:

We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 h of admission and stroke classified based on brain computed tomography scan or magnetic resonance imaging. Stroke severity at baseline was assessed using the Stroke Levity Scale (SLS), whereas 1-month outcome was assessed using the modified Rankin Scale (mRS).

RESULTS:

Patients' mean age was 58.4 ± 13.4 years, 490 were men (55%) and 400 were women (45%), 65.5% had ischemic stroke, and 85.4% had at least 1 ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%; p = 0.002), but more likely to have left ventricular hypertrophy (64.4% vs. 51.4%; p = 0.004). Odds of severe disability or death at 1 month were higher with severe stroke (AOR: 2.25; 95% confidence interval: 1.44 to 3.50), or atrial enlargement (AOR: 1.45; 95% confidence interval: 1.04 to 2.02).

CONCLUSIONS:

About 4 in 5 acute stroke patients in this African cohort had evidence of a baseline ECG abnormality, but presence of any atrial enlargement was the only independent ECG predictor of death or disability.

PMID:
28302557
PMCID:
PMC5582979
DOI:
10.1016/j.gheart.2017.01.002
[Indexed for MEDLINE]
Free PMC Article

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