title: Prevalence and impact on outcome of electrocardiographic early repolarization patterns among stroke patients: a prospective observational study.
abstract: BACKGROUND
  Early repolarization pattern (ER) gained attention as a risk factor for ventricular arrhythmia and sudden cardiac death in the general population. While electrocardiographic abnormalities are frequent findings in stroke patients, data on ER pattern in this population are lacking.
  
  
  METHODS
  We assessed the prevalence of ER pattern in consecutive acute stroke patients at a tertiary stroke center. Functional outcome after 90 days was analyzed to determine the effect of an ER pattern on mortality. Multivariate logistic regression analysis was used to identify factors associated with an ER pattern.
  
  
  RESULTS
  Out of 1141 consecutive stroke patients 771 patients remained for analysis after application of exclusion criteria. ER was observed in 62 (8.04%) patients. ER was more prevalent among subjects with intracerebral and subarachnoidal hemorrhage (13.0%) than among patients with ischemic stroke (7.0%; p = 0.024). Multiple regression analysis revealed QRS-duration (OR 0.972 95% CI 0.950-0.994, p = 0.012), QT-duration (OR 1.009, 95% CI 1.004-1.014, p = 0.001) and mechanical ventilation on admission (OR 0.320, 95% CI 0.136-0.752, p = 0.009) as independent predictors for ER. Overall ER on admission was not associated with increased mortality at 3-month follow-up (ER 11.3% vs. non-ER 9.2%; p = 0.582).
  
  
  CONCLUSIONS
  ER is frequently found among patients with acute cerebrovascular events and is more prevalent in patients with hemorrhagic compared to ischemic events. Our study yields no evidence that ER is associated with worse outcome or mortality after stroke.
authors.affiliation: Department of Neurology, Universitätsklinikum Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany, tobias.bobinger@uk-erlangen.de.
authors.forename: Tobias
authors.initials: T
authors.lastname: Bobinger
authors.forename: Bernd
authors.initials: B
authors.lastname: Kallmünzer
authors.forename: Markus
authors.initials: M
authors.lastname: Kopp
authors.forename: Natalia
authors.initials: N
authors.lastname: Kurka
authors.forename: Martin
authors.initials: M
authors.lastname: Arnold
authors.forename: Max-Josef
authors.initials: MJ
authors.lastname: Hilz
authors.forename: Hagen B
authors.initials: HB
authors.lastname: Huttner
authors.forename: Stefan
authors.initials: S
authors.lastname: Schwab
authors.forename: Martin
authors.initials: M
authors.lastname: Köhrmann
mesh_terms: D000200:Action Potentials; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D005858:Germany / Q000453:epidemiology; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D062606:Tertiary Care Centers; D013997:Time Factors