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QT prolongation predicts short-term mortality independent of comorbidity

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 an...

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Autores principales: Gibbs, Charlotte, Thalamus, Jacob, Kristoffersen, Doris Tove, Svendsen, Martin Veel, Holla, Øystein L, Heldal, Kristian, Haugaa, Kristina H, Hysing, Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680365/
https://www.ncbi.nlm.nih.gov/pubmed/31220237
http://dx.doi.org/10.1093/europace/euz058
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author Gibbs, Charlotte
Thalamus, Jacob
Kristoffersen, Doris Tove
Svendsen, Martin Veel
Holla, Øystein L
Heldal, Kristian
Haugaa, Kristina H
Hysing, Jan
author_facet Gibbs, Charlotte
Thalamus, Jacob
Kristoffersen, Doris Tove
Svendsen, Martin Veel
Holla, Øystein L
Heldal, Kristian
Haugaa, Kristina H
Hysing, Jan
author_sort Gibbs, Charlotte
collection PubMed
description 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.
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spelling pubmed-66803652019-08-07 QT prolongation predicts short-term mortality independent of comorbidity Gibbs, Charlotte Thalamus, Jacob Kristoffersen, Doris Tove Svendsen, Martin Veel Holla, Øystein L Heldal, Kristian Haugaa, Kristina H Hysing, Jan Europace Clinical Research 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. Oxford University Press 2019-08 2019-04-08 /pmc/articles/PMC6680365/ /pubmed/31220237 http://dx.doi.org/10.1093/europace/euz058 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Research
Gibbs, Charlotte
Thalamus, Jacob
Kristoffersen, Doris Tove
Svendsen, Martin Veel
Holla, Øystein L
Heldal, Kristian
Haugaa, Kristina H
Hysing, Jan
QT prolongation predicts short-term mortality independent of comorbidity
title QT prolongation predicts short-term mortality independent of comorbidity
title_full QT prolongation predicts short-term mortality independent of comorbidity
title_fullStr QT prolongation predicts short-term mortality independent of comorbidity
title_full_unstemmed QT prolongation predicts short-term mortality independent of comorbidity
title_short QT prolongation predicts short-term mortality independent of comorbidity
title_sort qt prolongation predicts short-term mortality independent of comorbidity
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680365/
https://www.ncbi.nlm.nih.gov/pubmed/31220237
http://dx.doi.org/10.1093/europace/euz058
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