Prolonged QT Interval and Coronary Artery Bypass Mortality Due to Heart Failure

Foroughi, Mahnoosh; Yousefi, Zahra; Tehrani, M Majidi; Foroutaghe, Azam Noori; Ghanavati, Arash; Hassantash, Seyed-Ahmad

doi:10.1177/0218492309349068

Cited by 10 publications

(14 citation statements)

References 13 publications

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“…QT-interval prolongation also affects the mortality rates of patients with a variety of diseases, including end-stage renal disease [16], coronary artery disease, congestive heart failure [17], diabetes mellitus [18], acute ischemic stroke [19], chronic liver disease [20], and chronic obstructive pulmonary disease [21]. Using a multivariate Cox regression model, we have demonstrated in this study that QTc interval prolongation might be an important risk factor for mortality after intentional organophosphate poisoning.…”

Section: Discussionmentioning

confidence: 62%

Heart Rate-Corrected QT Interval Helps Predict Mortality after Intentional Organophosphate Poisoning

et al. 2012

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IntroductionIn this study, we investigated the outcomes for patients with intentional organophosphate poisoning. Previous reports indicate that in contrast to normal heart rate-corrected QT intervals (QTc), QTc prolongation might be indicative of a poor prognosis for patients exposed to organophosphates.MethodsWe analyzed the records of 118 patients who were referred to Chang Gung Memorial Hospital for management of organophosphate poisoning between 2000 and 2011. Patients were grouped according to their initial QTc interval, i.e., normal (<0.44 s) or prolonged (>0.44 s). Demographic, clinical, laboratory, and mortality data were obtained for analysis.ResultsThe incidence of hypotension in patients with prolonged QTc intervals was higher than that in the patients with normal QTc intervals (P = 0.019). By the end of the study, 18 of 118 (15.2%) patients had died, including 3 of 75 (4.0%) patients with normal QTc intervals and 15 of 43 (34.9%) patients with prolonged QTc intervals. Using multivariate-Cox-regression analysis, we found that hypotension (OR = 10.930, 95% CI = 2.961–40.345, P = 0.000), respiratory failure (OR = 4.867, 95% CI = 1.062–22.301, P = 0.042), coma (OR = 3.482, 95% CI = 1.184–10.238, P = 0.023), and QTc prolongation (OR = 7.459, 95% CI = 2.053–27.099, P = 0.002) were significant risk factors for mortality. Furthermore, it was revealed that non-survivors not only had longer QTc interval (503.00±41.56 versus 432.71±51.21 ms, P = 0.002), but also suffered higher incidences of hypotension (83.3 versus 12.0%, P = 0.000), shortness of breath (64 versus 94.4%, P = 0.010), bronchorrhea (55 versus 94.4%, P = 0.002), bronchospasm (50.0 versus 94.4%, P = 0.000), respiratory failure (94.4 versus 43.0%, P = 0.000) and coma (66.7 versus 11.0%, P = 0.000) than survivors. Finally, Kaplan-Meier analysis demonstrated that cumulative mortality was higher among patients with prolonged QTc intervals than among those with normal QTc intervals (Log-rank test, Chi-square test = 20.36, P<0.001).ConclusionsQTc interval helps predict mortality after intentional organophosphate poisoning.

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Section: Discussionmentioning

confidence: 62%

Heart Rate-Corrected QT Interval Helps Predict Mortality after Intentional Organophosphate Poisoning

et al. 2012

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“…It is routinely used as an indicator of potential risk of proarrhythmia, such as impending torsades de pointes, ventricular fibrillation, and sudden death. 19,20 The cardiovascular complication rate is increased in high-risk patients with prolonged QT intervals. 17 QTd, as a noninvasive method, is a marker of myocardial electrical instability and a predictor of arrhythmic events.…”

Section: Discussionmentioning

confidence: 99%

QT Intervals in Patients Receiving a Renal Transplant

Monfared

Z²,

Salari³

et al. 2012

Exp Clin Transplant

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Objectives: Cardiovascular disease is the mostcommon cause of mortality in patients with endstage renal disease and renal transplant. Prolongation of QTc max and QTc dispersion are risk factors of cardiac arrhythmias and mortality. This study compares the changes of QT parameters before hemodialysis, after hemodialysis, and after renal transplant. Materials and Methods: Patient candidates for renal transplant were selected. Mean serum electrolyte and 12-lead electrocardiogram were recorded (1) immediately, (2) before and, (3) after the last dialysis session before renal transplant, (4) and 2 weeks after a kidney transplant in 34 patients with normal graft function (plasma Cr ≤ 176.8 µmol/L). Each QT interval was corrected for the patient's heart rate using Bazett's formula. The QT parameters (QTd, QTcd, QTc max ) were compared between prehemodialysis, posthemodialysis, and 2 weeks after renal transplant using a paired t test and a general liner model repeated measure. The correlation between QT parameter changes and serum electrolyte and acidbase alternation was analyzed. Results: The corrected maximal QT interval (QTc max ) decreased significantly after successful renal transplant compared to prehemodialysis (P = .002) and posthemodialysis (P = .003) with a paired t test and a General Liner Model Repeated Measure (P < .001) between the 3 groups. Also, the mean of

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“…In a follow‐up study 1 month postoperatively, Vrtovec et al compared cardiac death in 567 ischemic heart failure patients with or without prolonged QTc who had undergone coronary artery bypass grafting and demonstrated that the preoperative QTc interval was significantly longer in patients who died than in survivors (476 ± 45 vs 434 ± 50, P < 0.001); preoperative QTc of >440 milliseconds was the only independent predictor of mortality in multivariate analysis (HR 4.97, P = 0.002) 4 . Foroughi et al assessed the prognostic value of QT interval for death due to low cardiac output in 198 patients undergoing coronary artery bypass grafting and reported that the mean QTc was significantly longer in patients who died than in the control group (480.7 ± 96.2 vs 425.4 ± 21.6, P = 0.039) 5 . Our results concur with these findings.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent population‐based study, QT prolongation was identified as an independent predictor of sudden cardiac death among patients with coronary artery disease 3 . Preoperative QT interval has been reported to be predictive of overall mortality after coronary artery bypass surgery 4, 5 . However, little is known about its significance as a risk predictor for sudden cardiac death after coronary bypass surgery.…”

Section: Introductionmentioning

confidence: 99%

“…3 Preoperative QT interval has been reported to be predictive of overall mortality after coronary artery bypass surgery. 4,5 However, little is known about its significance as a risk predictor for sudden cardiac death after coronary bypass surgery. Although surgical revascularization may affect the QT interval, there is almost no information on the time course of QT interval after surgery.…”

Section: Introductionmentioning

confidence: 99%

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