A Novel Electrocardiographic Marker to Predicting Total Mortality in Ischemic Stroke: Frontal QRS-T Angle

OBJECTIVE
This study aimed to investigate the relationship between mortality and the frontal QRS-T angle (FQRS-TA), which has been obtained by calculating the absolute difference of QRS and T waves electrocardiographically (ECG), in patients diagnosed with ischemic stroke (IS).


METHODS
The research is a retrospective and cross-sectional study. The diagnosis of IS was confirmed from the brain images and physical examination. Patients with sinus rhythm were included in the study. FQRS-TA was measured by calculating the absolute difference between the QRS-axis and the T-axis automatically measured on the ECG. Patients were divided into two groups: those who died within 5 years and those who survived and were compared. P-values below 0.05 were considered significant.


RESULTS
A total of 322 IS were included in the study, 290 of whom lived and 32 died. Age, creatinine level, PR interval, QRS duration, cQT value, and FQRS-TA value (p < 0.05) were found higher in the death group.COX regression analyses were performed to examine the association between predictors of stroke-related mortality. Age [HR: 1.091, 95% (1.045-1.140), p<0.001], HDL [HR: 0.914, 95% (0.875-0.955), p<0.001] and FQRS-TA [OR: 1.011, 95% (1.003). -1.019) p=0.007] was associated with mortality. A FQRS-TA of 68 degrees or above was associated with cumulative mortality in the Kaplan-Meier survival analysis. (Log Rank [Mantel-Cox]: p=0.001).


CONCLUSION
In our study, we found that increased FQRS-TA was associated with mortality in IS patients.ECG parameters are simple and not time-consuming measurements and can provide important information about the patient's prognosis. According to our knowledge so far, this research is the first study on mortality in FQRS-TA and IS patients.