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J-curve relationship between corrected QT interval and mortality in acute heart failure patients

Authors
 Chan Soon Park  ;  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 
Citation
 KOREAN JOURNAL OF INTERNAL MEDICINE, Vol.35(6) : 1371-1384, 2020-11 
Journal Title
KOREAN JOURNAL OF INTERNAL MEDICINE
ISSN
 1226-3303 
Issue Date
2020-11
Keywords
Heart failure ; Mortality ; Prognosis ; QTc interval ; Sex
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. Conclusion: 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.
Files in This Item:
T202006785.pdf Download
DOI
10.3904/kjim.2019.030
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182746
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