J-curve relationship between corrected QT interval and mortality in acute heart failure patients
- Author:
Chan Soon PARK
1
;
Hyun-Jai CHO
;
Eue-Keun CHOI
;
Sang Eun LEE
;
Min-Seok KIM
;
Jae-Joong KIM
;
Jin-Oh CHOI
;
Eun-Seok JEON
;
Kyung-Kuk HWANG
;
Shung Chull CHAE
;
Sang Hong BAEK
;
Seok-Min KANG
;
Byungsu YOO
;
Dong-Ju CHOI
;
Youngkeun AHN
;
Kye-Hoon KIM
;
Myeong-Chan CHO
;
Byung-Hee OH
;
Hae-Young LEE
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2020;35(6):1371-1384
- CountryRepublic of Korea
-
Abstract:
Background/Aims:This study investigated the prognostic power of corrected QT (QTc) interval in patients with acute heart failure (AHF) according to sex.
Methods:We analyzed multicenter Korean Acute Heart Failure registry with patients with AHF admitted from 2011 to 2014. Among them, we analyzed 4,990 patients who were followed up to 5 years. Regarding QTc interval based on 12 lead electrocardiogram, patients were classified into quartiles according to sex.
Results:During follow-up with median 43.7 months, 2,243 (44.9%) patients died. The relationship between corrected QT interval and all-cause mortality followed a J-curve relationship. In Kaplan-Meier analysis, both sex had lowest mortality in the second QTc quartile. There were significant prognostic differences between the second and the fourth quartiles in male (log-rank p = 0.002), but not in female (log-rank p = 0.338). After adjusting covariates, the third (hazard ratio [HR], 1.185; 95% confidence interval [CI], 1.001 to 1.404; p = 0.049) and the fourth (HR, 1.404; 95% CI, 1.091 to 1.535; p = 0.003) quartiles demonstrated increased risk of mortality compared to the second quartile in male. In female, however, there was no significant difference across quartiles. QTc interval was associated with 5-year all-cause mortality in J-shape with nadir of 440 to 450 ms in male and 470 to 480 ms in female.
Conclusions:QTc interval was an independent predictor of overall death in male, but its significance decreased in female. The relationship between QTc interval and all-cause mortality was J-shaped in both sex.
