QT prolongation predicts short-term mortality independent of comorbidity

Abstract

Aims A prolonged corrected QT interval (QTc) ≥500 ms is associated with high all-cause mortality in hospitalized patients. We aimed to explore any difference in short- and long-term mortality in patients with QTc ≥500 ms compared with patients with QTc <500 ms after adjustment for comorbidity and main diagnosis. Methods and results Patients with QTc ≥500 ms who were hospitalized at Telemark Hospital Trust, Norway between January 2007 and April 2014 were identified. Thirty-day and 3-year all-cause mortality in 980 patients with QTc ≥500 ms were compared with 980 patients with QTc <500 ms, matched for age and sex and adjusting for Charlson comorbidity index (CCI), previous admissions, and main diagnoses. QTc ≥500 ms was associated with increased 30-day all-cause mortality [hazard ratio (HR) 1.90, 95% confidence interval (CI) 1.38–2.62; P < 0.001]. There was no significant difference in mortality between patients with QTc ≥500 ms and patients with QTc <500 ms who died between 30 days and 3 years; 32% vs. 29%, P = 0.20. Graded CCI was associated with increased 3-year all-cause mortality (CCI 1–2: HR 1.62, 95% CI 1.34–1.96; P < 0.001; CCI 3–4: HR 2.50, 95% CI 1.95–3.21; P < 0.001; CCI ≥5: HR 3.76, 95% CI 2.85–4.96; P < 0.001) but was not associated with 30-day all-cause mortality. Conclusion QTc ≥500 ms is a powerful predictor of short-term mortality overruling comorbidities. QTc ≥500 ms also predicted long-term mortality, but this effect was mainly caused by the increased short-term mortality. For long-term mortality, comorbidity was more important.

Association of worsening of nonalcoholic fatty liver disease with cardiometabolic function and intestinal bacterial overgrowth: A cross-sectional study

“…QTc and QRS prolongation has been reported in patients with NAFLD [25,26]. The prolongation of these intervals is known to be arrhythmogenic and a predictor of cardiac mortality [27,28]. In our sample, we noticed higher significant values of QRS interval between individuals with steatosis when compared to the control group, despite values less than 120ms.…”

QTc evaluation in patients with bundle branch block

“…An increase in the baseline QT interval (for every 10 ms) was associated with increased incidence for heart failure, cardiovascular disease events and stroke [11] . Compared to patients with QT intervals below 500 ms, patients with QT intervals above 500 ms are exposed to a higher short-term mortality risk, independent from the underlying comorbidities, [12] . Additionally, QT-prolongation has been described as a prognostic parameter in Non-ST-Elevation Myocardial Infarction (NSTEMI) patients.…”

Decompressive Craniectomy Improves QTc Interval in Traumatic Brain Injury Patients

“…Prolonged QTc, longer than 470 ms, has been shown to be an independent risk factor for the development of life-threatening cardiac arrhythmias in patients with subarachnoid hemorrhage [ 10 ]. There is also strong evidence that prolonged QTc (>500 ms) as well as widened spQRS-T more than 120° for men and 90° for women are risk factors for life-threatening cardiac arrhythmias and sudden cardiac death not only in TBI patients, but also in the general population [ 11 , 12 , 13 ]. Of note, prolonged QTc interval reflects disorders in cardiac repolarization and widened spQRS-T the difference between ventricular depolarization and repolarization [ 11 , 12 , 13 ].…”