Association of corrected QT interval with long-term mortality in patients with syncope

Balasubramaniyam, Nivas; Palaniswamy, Chandrasekar; Aronow, Wilbert S.; Khera, Sahil; Balasubramanian, Gokulakrishnan; Harikrishnan, Prakash; Doshi, Jay; Nabors, Christopher; Peterson, Stephen J.; Sule, Sachin

doi:10.5114/aoms.2013.39383

Cited by 10 publications

(11 citation statements)

References 20 publications

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“…A potential explanation for these associations include confounding by conditions and complications that may have necessitated the longer LoS [22,23]. However, the findings of our study may not be explained by the subset of very sick patients with unusually long LoS, as we found similar results when we repeated our analysis after excluding those with LoS > 10 days.…”

Section: Discussionsupporting

confidence: 60%

Length of stay and readmission in older adults hospitalized for heart failure

et al. 2021

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Introduction: Hospital length of stay (LoS) and hospital readmissions are metrics of healthcare performance. We examined the association between these two metrics in older patients hospitalized with decompensated heart failure (HF). Material and methods: Eight thousand and forty-nine patients hospitalized for HF in 106 U.S. hospitals had a median LoS of 5 days; among them, 3777 had a LoS > 5 days. Using propensity scores for LoS > 5 days, we assembled 2723 pairs of patients with LoS 1-5 vs. > 5 days. The matched cohort of 5446 patients was balanced on 40 baseline characteristics. We repeated the above process in 7045 patients after excluding those with LoS > 10 days, thus assembling a second matched cohort of 2399 pairs of patients with LoS 1-5 vs. 6-10 days. Hazard ratios (HR) and 95% confidence intervals (CI) for outcomes associated with longer LoS were estimated in matched cohorts. Results: In the primary matched cohort (n = 5446), LoS > 5 days was associated with a higher risk of all-cause readmission at 30 days (HR = 1.16; 95% CI: 1.04-1.31; p = 0.010), but not during longer follow-up. A longer LoS was also associated with a higher risk of mortality during 8.8 years of follow-up (HR = 1.13; 95% CI: 1.06-1.21; p < 0.001). LoS had no association with HF readmission. Similar associations were observed among the matched sensitivity cohort (n = 4798) that excluded patients with LoS > 10 days. Conclusions: In propensity score-matched balanced cohorts of patients with HF, a longer LoS was independently associated with poor outcomes, which persisted when LoS > 10 days were excluded.

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Section: Discussionsupporting

confidence: 60%

Length of stay and readmission in older adults hospitalized for heart failure

et al. 2021

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“…In general, the presence of a prolonged QTc interval on the ECG in a patient who is admitted to the hospital because of syncope represents an independent predictor of long-term mortality [ 6 ]. The majority of QT prolonging drugs block the cardiac rapidly activating delayed rectifier potassium current ( I kr ), whose major subunit is encoded by the human ether-a-go-go related gene (HERG) [ 7 , 8 ].…”

mentioning

confidence: 99%

An unusual etiology of torsade de pointes-induced syncope

Morosin¹,

Dametto²,

Bianco³

et al. 2017

aoms

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“…After analysis of the Holter recordings, participants underwent a HUTT, including BP measurements, HR, and an electrocardiographic recording for the diagnosis of VVS. The test confirmed the etiology of syncope [18] due to dysfunction of the ANS dysautonomia as well as susceptibility to VVS [16,19,20].…”

Section: Head-up Tilt Test (Hutt)mentioning

confidence: 70%

Anabolic androgenic steroid users: a tilt test study with young adult men

Puppin¹,

Moraes²,

Gomes³

et al. 2019

Arch Med Sci Civil Dis

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Introduction: Anabolic androgenic steroids (AASs) can induce cardiac dysautonomia, which is related to arrhythmias, vasovagal syncope (VVS) and sudden death. The aim of this study was to determine whether the use of AASs increases the susceptibility for VVS or autonomic dysfunction in AAS users by the head-up tilt test (HUTT). Material and methods: Cross-sectional observational study conducted with physically active young men, users (AAS group; n = 10) and non-users (Control group, n = 13) of AAS. The history of physical activity and age of each participant were recorded and the following examinations were performed: physical, biochemical, hormonal, electrocardiogram (ECG), 24-hour Holter recorder equipment. The 24-hour Holter and HUTT were conducted to detect the presence of arrhythmias/heart rate variability, and VVS/dysautonomia, respectively. Of the 28 participants recruited, 5 were excluded for not having completed the examinations. Results: Compared with non-users, users of AAS showed an increase in aspartate aminotransferase (Control: 29.7 ±1.8; AAS: 49.9 ±9.0 UI/l; p < 0.05), in ventricular extrasystoles (Control: 2.5 ±2.3; AAS: 14.9 ±11.2, p < 0.05), and reduction in the pNN50 index of Holter (Control: 24.3 ±4.0%; AAS: 14.8 ±4.0%, p < 0.05). The HUTT showed that the maximum value of diastolic blood pressure was increased in the AAS user group (Control: 78.3 ±2.1; AAS: 90.0 ±5.4 mm Hg, p < 0.05). Conclusions: The study showed that the use of AAS is able to promote an autonomic dysfunction, with a ventricular arrhythmia. In addition it was found that among AAS users there was a positive result for the HUTT.

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Association of corrected QT interval with long-term mortality in patients with syncope

Cited by 10 publications

References 20 publications

Length of stay and readmission in older adults hospitalized for heart failure

Length of stay and readmission in older adults hospitalized for heart failure

An unusual etiology of torsade de pointes-induced syncope

Anabolic androgenic steroid users: a tilt test study with young adult men

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