QT prolongation is an independent predictor of mortality in end-stage renal disease.

  • Hage F
  • de Mattos A
  • Khamash H
 et al. 
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Abstract

BACKGROUND: Coronary artery disease (CAD) is the predominant cause of sudden cardiac death in the general population, and sudden cardiac death is the leading cause of mortality in end-stage renal disease (ESRD). HYPOTHESIS: QT-interval prolongation is an independent prognosticator in ESRD. METHODS: We reviewed clinical, electrocardiographic, stress test, and coronary angiography data on ESRD patients evaluated for transplantation at our institution between 2000 and 2004 who underwent coronary angiography. The QT interval was corrected for heart rate and QRS duration (QTc). All-cause mortality data were prospectively collected and verified against the Social Security Death Index database. RESULTS: During 40 +/- 28 months of follow-up, 132 of the 280 (47%) patients died prior to renal transplantation. Patients with a prolonged QTc (39%) had 1-, 3-, and 5-year death-rates of 12%, 36%, and 47%, respectively, vs 8%, 24%, and 36% for those with normal QTc (log-rank P = 0.03). In a multivariate Cox regression model that adjusted for age, gender, diabetes mellitus, myocardial infarction, presence and severity of CAD on angiography, left ventricular (LV) hypertrophy, LV ejection fraction (EF), and multiple other variables, QTc remained to be an independent predictor of survival (hazard ratio [HR]: 1.008, 95% confidence interval [CI]: 1.001-1.014, P = 0.016). Female gender, decreasing LVEF, and decreasing severity of CAD on angiography were independent predictors of prolonged QTc. CONCLUSIONS: QTc prolongation is an independent predictor of mortality in ESRD patients being evaluated for renal transplantation. The prognostic information gained from the QTc is additive to that provided by the LVEF and the severity of CAD.

Author-supplied keywords

  • Adulto
  • Alabama/epidemiología
  • Anciano
  • Angiografía Coronaria
  • Arritmias Cardíacas/diagnóstico
  • Arritmias Cardíacas/fisiopatología
  • Arritmias Cardíacas/mortalidad
  • Bases de Datos como Asunto
  • Distribución de Chi-Cuadrado
  • Electrocardiografía
  • Enfermedad de la Arteria Coronaria/diagnóstico
  • Enfermedad de la Arteria Coronaria/fisiopatología
  • Enfermedad de la Arteria Coronaria/mortalidad
  • Estimación de Kaplan-Meier
  • Estudios Prospectivos
  • Factores de Riesgo
  • Factores de Tiempo
  • Fallo Renal Crónico/cirugía
  • Fallo Renal Crónico/fisiopatología
  • Fallo Renal Crónico/mortalidad
  • Femenino
  • Frecuencia Cardíaca
  • Función Ventricular Izquierda
  • Humanos
  • Masculino
  • Mediana Edad
  • Medición de Riesgo
  • Modelos Logísticos
  • Modelos de Riesgos Proporcionales
  • Potenciales de Acción
  • Pronóstico
  • Prueba de Esfuerzo
  • Supervivencia sin Enfermedad
  • Trasplante de Riñón
  • Volumen Sistólico

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Authors

  • Fadi G Hage

  • Angelo M de Mattos

  • Hasan Khamash

  • Shikha Mehta

  • David Warnock

  • Ami E Iskandrian

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