Letter to the Editor Prevalence of electrocardiographic ST-T changes during acute ischemic stroke in patients without known ischemic heart disease Jesper K. Jensen a, ⁎ , Søren Bak b , Poul Flemming Høilund-Carlsen c , Hans Mickley a a Department of Cardiology, Odense University Hospital, Denmark b Department of Neurology, Odense University Hospital, Denmark c Department of Nuclear Medicine, Odense University Hospital, Denmark Received 21 March 2007; accepted 9 May 2007 Available online 1 August 2007 Abstract We evaluated characteristics and prevalence of ST-segment depression and/or T-wave inversion in the resting electrocardiogram of 244 consecutive patients with acute ischemic stroke, but without ischemic heart disease. The prevalence of ST-T changes ranged from 13% to 16% and this is what to expect in the background population. © 2007 Elsevier Ireland Ltd. All rights reserved. Keywords: Ischemic stroke; Acute; Electrocardiography; ST-segment depression; T wave inversion Electrocardiographic (ECG) changes suggestive of myo- cardial ischemia, i.e., ST segment and/or T wave abnormal- ities (ST-T changes) have been suggested in patients with ischemic stroke.[1] The prevalence of these changes differs considerable. In addition, data addressing potential confoun- ders that may influence the interpretation of ST-T changes are often limited. Accordingly, we prospectively studied patients with acute ischemic stroke – but without known ischemic heart disease – in order to assess the prevalence of ST-T changes in the resting ECG during an acute ischemic stroke. 1. Study population The study population of the 244 consecutive patients with acute ischemic stroke and definitions used has been previously described [2] Stroke subtypes were classified according to the Oxfordshire Community Stroke Project.[3] The study was approved by the local ethics committee, and informed consent was obtained from each patient or a family member. 2. Statistical analysis Statistical analysis was performed with Fischer's exact test, the Wilcoxon rank sum test, Student's t-test, and the Stuart–Maxwell test were applied when appropriate. In all tests, a P-value b 0.05 two-tailed was considered statistically significant. The data analyses were performed using STATA/ SE 8.0 for Windows. 3. Results During ECG recording 18 patients had paroxystic atrial fibrillation. Three patients had pace rhythm and/or left bundle branch block. These ECGs were not evaluated for ST-T chan- ges. LVH with ST-T changes was found in 9 (4%) patients, who were excluded from further analysis. From day 0 to day 5, ST-T changes were demonstrated at least once in 59 (24%) patients (Table 1). There was no difference in baseline charac- teristics between the two groups. None of the patients had chest discomfort. The prevalence of ST-T changes from day 0 through day 5 ranged from 13% to 16%. Two patients had International Journal of Cardiology 128 (2008) 137 – 138 www.elsevier.com/locate/ijcard ⁎ Corresponding author. Department of Cardiology, Odense University Hospital, DK-5000 Odense C, Denmark. Tel.: +45 6612 2420; fax: +45 6312 0854. E-mail address: jesperkjensen@dadlnet.dk (J.K. Jensen). 0167-5273/$ - see front matter © 2007 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2007.05.055