1. Prevalence and Prognostic Features of ECG Abnormalities in Acute Stroke: Findings From the SIREN Study Among Africans.
- Author
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Adeoye AM, Ogah OS, Ovbiagele B, Akinyemi R, Shidali V, Agyekum F, Aje A, Adebayo O, Akinyemi JO, Kolo P, Appiah LT, Iheonye H, Kelechukwu U, Ganiyu A, Olunuga TO, Akpa O, Olagoke OO, Sarfo FS, Wahab K, Olowookere S, Fakunle A, Akpalu A, Adebayo PB, Nkromah K, Yaria J, Ibinaiye P, Ogbole G, Olumayowa A, Lakoh S, Calys-Tagoe B, Olowoyo P, Innocent C, Tiwari HK, Arnett D, Godwin O, Ayotunde B, Akpalu J, Obiora O, Joseph O, Omisore A, Jenkins C, Lackland D, Owolabi L, Isah S, Dambatta AH, Komolafe M, Bock-Oruma A, Melikam ES, Imoh LC, Sunmonu T, Gebregziabher M, Olabisi O, Armstrong K, Onyeonoro UU, Sanya E, Agunloye AM, Ogunjimi L, Arulogun O, Farombi TH, Obiabo O, Obiako R, and Owolabi M
- Subjects
- Arrhythmias, Cardiac complications, Arrhythmias, Cardiac physiopathology, Brain diagnostic imaging, Cardiomyopathy, Hypertrophic complications, Cardiomyopathy, Hypertrophic physiopathology, Cross-Sectional Studies, Female, Ghana epidemiology, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Nigeria epidemiology, Prevalence, Prognosis, Retrospective Studies, Severity of Illness Index, Stroke etiology, Stroke physiopathology, Survival Rate trends, Tomography, X-Ray Computed, Electrocardiography, Heart Rate physiology, Stroke epidemiology
- 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., (Copyright © 2017 World Heart Federation (Geneva). All rights reserved.)
- Published
- 2017
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