Risk Factors for Cardiac Death in Patients with a Transient Ischemic Attack or Ischemic Stroke

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Abstract
740 patients who underwent 24-hour ECG for a neurological indication, including transient ischemic attack (TIA) or ischemic stroke, were followed for 4.7 years. During follow-up, 262 patients died. After reviewing the causes of death and the indication for 24-hour ECG, we identified 86 patients with a TIA or ischemic stroke who died from a cardiac cause. These cases were compared with 118 control patients with a TIA or ischemic stroke who survived during follow-up or died from a noncardiac cause. The aim of this study was to investigate the relationship between neurological and cardiac history, 12-lead ECG, precordial echocardiography and 24-hour ECG, and the occurrence of cardiac death. The following independent risk factors were identified by means of logistic regression: previous myocardial infarction; diabetes mellitus; pulmonary disease; intraventricular conduction defect or T wave abnormalities on standard ECG, and ventricular tachycardia, multiform ventricular premature complex and doublet or bigeminy on 24-hour ECG. Prognosis with regard to the occurrence of cardiac death in patients with TIA or ischemic stroke depends on cardiac risk factors; none of the neurological variables predicted cardiac death.

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