Clinical implications of QRS duration and QT peak prolongation in patients with suspected coronary disease referred for elective cardiac catheterization
| Autor: | M.R.C.P. M. Nadeem Attar M.D., M.R.C.P. Nick Newall M.D., F.R.C.P. David R. Ramsdale M.D., David G. Groves, M.R.C.P. Kenneth Wong M.D., M.R.C.P. Roger K. Moore M.D. |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Cardiac Catheterization medicine.medical_treatment Myocardial Infarction Coronary Disease Coronary Angiography Risk Assessment Sensitivity and Specificity Severity of Illness Index Coronary artery disease Cohort Studies QRS complex Electrocardiography Ventricular Dysfunction Left Heart Conduction System Predictive Value of Tests Physiology (medical) Internal medicine medicine Clinical endpoint Humans Myocardial infarction Cardiac catheterization Aged Proportional Hazards Models Retrospective Studies medicine.diagnostic_test Proportional hazards model business.industry General Medicine Original Articles Middle Aged medicine.disease Survival Analysis Heart failure Multivariate Analysis Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc. 13(2) |
| ISSN: | 1542-474X |
| Popis: | Background: The electrocardiogram (ECG) remains a simple, universally available, and prognostically powerful investigation in heart failure, and acute coronary syndromes. We sought to assess the prognostic utility of clinical, angiographic, and simple ECG parameters in a large cohort of patients undergoing elective cardiac catheterization (CC) for known or suspected coronary artery disease. Methods: Consecutive consenting patients undergoing CC for coronary disease were enrolled at a single tertiary center. Patient data, drug therapy, catheter reports, and ECG recordings were prospectively recorded in a validated electronic archive. The primary outcome measure was death or nonfatal myocardial infarction (MI) over 1 year or until percutaneous or cardiac surgical intervention. Independent prognostic markers were identified using the Cox proportional hazard model. Results: A total of 682 individuals were recruited of whom 17(2.5%) died or suffered a nonfatal MI in 1 year. In multivariate analysis QRS duration (ms) (HR 1.03 95% CI 1.01–1.05, P = 0.003), extent of coronary disease (HR 2.01 95% CI 1.24–3.58, P = 0.006), and prolonged corrected QT peak interval in lead I (HR 1.02 95% CI 1.00–1.03, P = 0.044) were independently associated with death or nonfatal MI. Receiver-operator characteristic (ROC) analysis for the multivariate model against the primary end point yielded an area under the curve of 0.759 (95% CI 0.660–0.858), P < 0.001. Conclusions: QRS duration and QT peak are independently associated with increased risk of death or nonfatal MI in stable patients attending for coronary angiography. |
| Databáze: | OpenAIRE |
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