Association of corrected QT interval with long-term mortality in patients with syncope

Nivas Balasubramaniyam, Chandrasekar Palaniswamy, Wilbert S. Aronow, Sahil Khera, Gokulakrishnan Balasubramanian, Prakash Harikrishnan, Jay V. Doshi, Christopher Nabors, Stephen J. Peterson, Sachin Sule

Research output: Contribution to journalArticle

Abstract

Introduction: The electrocardiographic parameters QRS duration, QRS-T angle and QTc can predict mortality in patients with cardiovascular disease. The prgnostic value of these parameters in hospitalized patients with syncope needs investigation. Material and methods: We retrospectively studied 590 consecutive patients hospitalized with syncope. After excluding patients with baseline abnormal rhythm, QT- prolonging medications, and missing data, 459 patients were analyzed. Baseline demographic characteristics, co-morbidities, medication use, San Francisco Syncope Rule (SFSR) and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) score and data on mortality were collected. The categorical variables and continuous variables of the 2 groups of patients with prolonged QTc and normal QTc interval were analyzed by Fischer's exact test and Mann-Whitney Test. A stepwise Cox regression model was used for time to death analysis. Results: Of 459 patients, prolonged QTc interval was observed in 122 (27%). Mean follow-up was 41 months. Patients with prolonged QTc interval had higher prevalence of cardiovascular disease, OESIL score, high risk SFSR, hypertension, dyslipidemia, coronary artery disease, congestive heart failure, and increased mortality. Stepwise Cox regression analysis showed that significant independent prognostic factors for time to death were prolonged QTc interval (p = 0.005), age (p = 0.001), diabetes mellitus (p = 0.001) and history of malignancy (p = 0.006). QRS duration and QRS-T angle were not independent predictors of mortality. Conclusions: A prolonged QTc interval is an independent predictor of long-term mortality in hospitalized patients with syncope.

Original languageEnglish (US)
Pages (from-to)1049-1054
Number of pages6
JournalArchives of Medical Science
Volume9
Issue number6
DOIs
StatePublished - Dec 1 2013
Externally publishedYes

Fingerprint

Syncope
Mortality
San Francisco
Cardiovascular Diseases
Dyslipidemias
Proportional Hazards Models
Coronary Artery Disease
Diabetes Mellitus
Heart Failure
Regression Analysis
Demography
Hypertension
Morbidity

Keywords

  • Mortality
  • QTc interval
  • Syncope

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Balasubramaniyam, N., Palaniswamy, C., Aronow, W. S., Khera, S., Balasubramanian, G., Harikrishnan, P., ... Sule, S. (2013). Association of corrected QT interval with long-term mortality in patients with syncope. Archives of Medical Science, 9(6), 1049-1054. https://doi.org/10.5114/aoms.2013.39383

Association of corrected QT interval with long-term mortality in patients with syncope. / Balasubramaniyam, Nivas; Palaniswamy, Chandrasekar; Aronow, Wilbert S.; Khera, Sahil; Balasubramanian, Gokulakrishnan; Harikrishnan, Prakash; Doshi, Jay V.; Nabors, Christopher; Peterson, Stephen J.; Sule, Sachin.

In: Archives of Medical Science, Vol. 9, No. 6, 01.12.2013, p. 1049-1054.

Research output: Contribution to journalArticle

Balasubramaniyam, N, Palaniswamy, C, Aronow, WS, Khera, S, Balasubramanian, G, Harikrishnan, P, Doshi, JV, Nabors, C, Peterson, SJ & Sule, S 2013, 'Association of corrected QT interval with long-term mortality in patients with syncope', Archives of Medical Science, vol. 9, no. 6, pp. 1049-1054. https://doi.org/10.5114/aoms.2013.39383
Balasubramaniyam N, Palaniswamy C, Aronow WS, Khera S, Balasubramanian G, Harikrishnan P et al. Association of corrected QT interval with long-term mortality in patients with syncope. Archives of Medical Science. 2013 Dec 1;9(6):1049-1054. https://doi.org/10.5114/aoms.2013.39383
Balasubramaniyam, Nivas ; Palaniswamy, Chandrasekar ; Aronow, Wilbert S. ; Khera, Sahil ; Balasubramanian, Gokulakrishnan ; Harikrishnan, Prakash ; Doshi, Jay V. ; Nabors, Christopher ; Peterson, Stephen J. ; Sule, Sachin. / Association of corrected QT interval with long-term mortality in patients with syncope. In: Archives of Medical Science. 2013 ; Vol. 9, No. 6. pp. 1049-1054.
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AU - Khera, Sahil

AU - Balasubramanian, Gokulakrishnan

AU - Harikrishnan, Prakash

AU - Doshi, Jay V.

AU - Nabors, Christopher

AU - Peterson, Stephen J.

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N2 - Introduction: The electrocardiographic parameters QRS duration, QRS-T angle and QTc can predict mortality in patients with cardiovascular disease. The prgnostic value of these parameters in hospitalized patients with syncope needs investigation. Material and methods: We retrospectively studied 590 consecutive patients hospitalized with syncope. After excluding patients with baseline abnormal rhythm, QT- prolonging medications, and missing data, 459 patients were analyzed. Baseline demographic characteristics, co-morbidities, medication use, San Francisco Syncope Rule (SFSR) and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) score and data on mortality were collected. The categorical variables and continuous variables of the 2 groups of patients with prolonged QTc and normal QTc interval were analyzed by Fischer's exact test and Mann-Whitney Test. A stepwise Cox regression model was used for time to death analysis. Results: Of 459 patients, prolonged QTc interval was observed in 122 (27%). Mean follow-up was 41 months. Patients with prolonged QTc interval had higher prevalence of cardiovascular disease, OESIL score, high risk SFSR, hypertension, dyslipidemia, coronary artery disease, congestive heart failure, and increased mortality. Stepwise Cox regression analysis showed that significant independent prognostic factors for time to death were prolonged QTc interval (p = 0.005), age (p = 0.001), diabetes mellitus (p = 0.001) and history of malignancy (p = 0.006). QRS duration and QRS-T angle were not independent predictors of mortality. Conclusions: A prolonged QTc interval is an independent predictor of long-term mortality in hospitalized patients with syncope.

AB - Introduction: The electrocardiographic parameters QRS duration, QRS-T angle and QTc can predict mortality in patients with cardiovascular disease. The prgnostic value of these parameters in hospitalized patients with syncope needs investigation. Material and methods: We retrospectively studied 590 consecutive patients hospitalized with syncope. After excluding patients with baseline abnormal rhythm, QT- prolonging medications, and missing data, 459 patients were analyzed. Baseline demographic characteristics, co-morbidities, medication use, San Francisco Syncope Rule (SFSR) and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) score and data on mortality were collected. The categorical variables and continuous variables of the 2 groups of patients with prolonged QTc and normal QTc interval were analyzed by Fischer's exact test and Mann-Whitney Test. A stepwise Cox regression model was used for time to death analysis. Results: Of 459 patients, prolonged QTc interval was observed in 122 (27%). Mean follow-up was 41 months. Patients with prolonged QTc interval had higher prevalence of cardiovascular disease, OESIL score, high risk SFSR, hypertension, dyslipidemia, coronary artery disease, congestive heart failure, and increased mortality. Stepwise Cox regression analysis showed that significant independent prognostic factors for time to death were prolonged QTc interval (p = 0.005), age (p = 0.001), diabetes mellitus (p = 0.001) and history of malignancy (p = 0.006). QRS duration and QRS-T angle were not independent predictors of mortality. Conclusions: A prolonged QTc interval is an independent predictor of long-term mortality in hospitalized patients with syncope.

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