QRS duration is associated with all-cause mortality in type 2 diabetes: The diabetes heart study
| Autor: | Krupal J. Hari, Georgia Saylor, Joseph Yeboah, Matthew J. Singleton, Donald W. Bowden, Prashant D. Bhave, Barry I. Freedman, Elsayed Z. Soliman, David M. Herrington, Charles A German |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Population Type 2 diabetes 030204 cardiovascular system & hematology 03 medical and health sciences Electrocardiography 0302 clinical medicine Risk Factors Internal medicine Diabetes mellitus medicine Humans cardiovascular diseases 030212 general & internal medicine education Aged Proportional Hazards Models Heart Failure education.field_of_study Proportional hazards model business.industry Hazard ratio Middle Aged medicine.disease Prognosis Blood pressure Diabetes Mellitus Type 2 Heart failure cardiovascular system Population study Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of electrocardiology. 58 |
| ISSN: | 1532-8430 |
| Popis: | Background QRS-duration predicts mortality in patients with heart failure and, to a lesser extent, the general population. However, in patients with diabetes, its prognostic significance is unknown. To better understand how QRS-duration relates to mortality among those with diabetes, we explored survival as a function of QRS-duration in the Diabetes Heart Study. Methods The study population included 1335 participants. Cox proportional hazards modeling was used to evaluate the relationship between QRS-duration and all-cause mortality, comparing those with QRS-duration ≤120 vs. >120 (ms). Multivariable models adjusted for age, sex, race, hypertension, smoking, years with diabetes, BMI, systolic blood pressure, cholesterol, triglycerides, glomerular filtration rate, and hemoglobin A1c. Results and conclusions Participants were: mean age 61 ± 9, 55% women, 83% white; 99 participants (7.5%) had a QRS-duration >120. After 11,000 person-years of follow-up (median 8.5 years; maximum 13.9 years), 266 participants had died (20%). Participants with baseline QRS-duration >120 had an adjusted hazard ratio for all-cause mortality of 1.56 (95% CI 1.05–2.24; p = 0.027). Modeling QRS-duration as a continuous variable, we found an 11% increase in all-cause mortality for each 10 ms increase in QRS-duration. In conclusion, QRS-duration is associated with subsequent all-cause mortality among those with type 2 diabetes—participants with QRS-duration >120 ms had a 56% increase in all-cause mortality, even after adjustment for conventional risk factors. Given the ubiquitous presence of ECG data in the medical record, QRS-duration may prove to be a useful prognostic measure, especially among those with diabetes. |
| Databáze: | OpenAIRE |
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