QT prolongation is an independent predictor of mortality in end-stage renal disease

Fadi G. Hage, Angelo M DeMattos, Hasan Khamash, Shikha Mehta, David Warnock, Ami E. Iskandrian

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Coronary artery disease (CAD) is the predominant cause of sudden cardiac death in the general population, and sudden cardiac death is the leading cause of mortality in end-stage renal disease (ESRD). Hypothesis: QT-interval prolongation is an independent prognosticator in ESRD. Methods: We reviewed clinical, electrocardiographic, stress test, and coronary angiography data on ESRD patients evaluated for transplantation at our institution between 2000 and 2004 who underwent coronary angiography. The QT interval was corrected for heart rate and QRS duration (QTc). All-cause mortality data were prospectively collected and verified against the Social Security Death Index database. Results: During 40 ± 28 months of follow-up, 132 of the 280 (47%) patients died prior to renal transplantation. Patients with a prolonged QTc (39%) had 1-, 3-, and 5-year death-rates of 12%, 36%, and 47%, respectively, vs 8%, 24%, and 36% for those with normal QTc (log-rank P = 0.03). In a multivariate Cox regression model that adjusted for age, gender, diabetes mellitus, myocardial infarction, presence and severity of CAD on angiography, left ventricular (LV) hypertrophy, LV ejection fraction (EF), and multiple other variables, QTc remained to be an independent predictor of survival (hazard ratio [HR]: 1.008, 95% confidence interval [CI]: 1.001-1.014, P = 0.016). Female gender, decreasing LVEF, and decreasing severity of CAD on angiography were independent predictors of prolonged QTc. Conclusions: QTc prolongation is an independent predictor of mortality in ESRD patients being evaluated for renal transplantation. The prognostic information gained from the QTc is additive to that provided by the LVEF and the severity of CAD.

Original languageEnglish (US)
Pages (from-to)361-366
Number of pages6
JournalClinical Cardiology
Volume33
Issue number6
DOIs
StatePublished - Jun 2010

Fingerprint

Chronic Kidney Failure
Coronary Artery Disease
Mortality
Sudden Cardiac Death
Coronary Angiography
Kidney Transplantation
Angiography
Social Security
Left Ventricular Hypertrophy
Exercise Test
Proportional Hazards Models
Stroke Volume
Diabetes Mellitus
Transplantation
Heart Rate
Myocardial Infarction
Databases
Confidence Intervals
Survival
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

QT prolongation is an independent predictor of mortality in end-stage renal disease. / Hage, Fadi G.; DeMattos, Angelo M; Khamash, Hasan; Mehta, Shikha; Warnock, David; Iskandrian, Ami E.

In: Clinical Cardiology, Vol. 33, No. 6, 06.2010, p. 361-366.

Research output: Contribution to journalArticle

Hage, FG, DeMattos, AM, Khamash, H, Mehta, S, Warnock, D & Iskandrian, AE 2010, 'QT prolongation is an independent predictor of mortality in end-stage renal disease', Clinical Cardiology, vol. 33, no. 6, pp. 361-366. https://doi.org/10.1002/clc.20768
Hage, Fadi G. ; DeMattos, Angelo M ; Khamash, Hasan ; Mehta, Shikha ; Warnock, David ; Iskandrian, Ami E. / QT prolongation is an independent predictor of mortality in end-stage renal disease. In: Clinical Cardiology. 2010 ; Vol. 33, No. 6. pp. 361-366.
@article{9ed8219752844081940c839e7563ba10,
title = "QT prolongation is an independent predictor of mortality in end-stage renal disease",
abstract = "Background: Coronary artery disease (CAD) is the predominant cause of sudden cardiac death in the general population, and sudden cardiac death is the leading cause of mortality in end-stage renal disease (ESRD). Hypothesis: QT-interval prolongation is an independent prognosticator in ESRD. Methods: We reviewed clinical, electrocardiographic, stress test, and coronary angiography data on ESRD patients evaluated for transplantation at our institution between 2000 and 2004 who underwent coronary angiography. The QT interval was corrected for heart rate and QRS duration (QTc). All-cause mortality data were prospectively collected and verified against the Social Security Death Index database. Results: During 40 ± 28 months of follow-up, 132 of the 280 (47{\%}) patients died prior to renal transplantation. Patients with a prolonged QTc (39{\%}) had 1-, 3-, and 5-year death-rates of 12{\%}, 36{\%}, and 47{\%}, respectively, vs 8{\%}, 24{\%}, and 36{\%} for those with normal QTc (log-rank P = 0.03). In a multivariate Cox regression model that adjusted for age, gender, diabetes mellitus, myocardial infarction, presence and severity of CAD on angiography, left ventricular (LV) hypertrophy, LV ejection fraction (EF), and multiple other variables, QTc remained to be an independent predictor of survival (hazard ratio [HR]: 1.008, 95{\%} confidence interval [CI]: 1.001-1.014, P = 0.016). Female gender, decreasing LVEF, and decreasing severity of CAD on angiography were independent predictors of prolonged QTc. Conclusions: QTc prolongation is an independent predictor of mortality in ESRD patients being evaluated for renal transplantation. The prognostic information gained from the QTc is additive to that provided by the LVEF and the severity of CAD.",
author = "Hage, {Fadi G.} and DeMattos, {Angelo M} and Hasan Khamash and Shikha Mehta and David Warnock and Iskandrian, {Ami E.}",
year = "2010",
month = "6",
doi = "10.1002/clc.20768",
language = "English (US)",
volume = "33",
pages = "361--366",
journal = "Clinical Cardiology",
issn = "0160-9289",
publisher = "John Wiley and Sons Inc.",
number = "6",

}

TY - JOUR

T1 - QT prolongation is an independent predictor of mortality in end-stage renal disease

AU - Hage, Fadi G.

AU - DeMattos, Angelo M

AU - Khamash, Hasan

AU - Mehta, Shikha

AU - Warnock, David

AU - Iskandrian, Ami E.

PY - 2010/6

Y1 - 2010/6

N2 - Background: Coronary artery disease (CAD) is the predominant cause of sudden cardiac death in the general population, and sudden cardiac death is the leading cause of mortality in end-stage renal disease (ESRD). Hypothesis: QT-interval prolongation is an independent prognosticator in ESRD. Methods: We reviewed clinical, electrocardiographic, stress test, and coronary angiography data on ESRD patients evaluated for transplantation at our institution between 2000 and 2004 who underwent coronary angiography. The QT interval was corrected for heart rate and QRS duration (QTc). All-cause mortality data were prospectively collected and verified against the Social Security Death Index database. Results: During 40 ± 28 months of follow-up, 132 of the 280 (47%) patients died prior to renal transplantation. Patients with a prolonged QTc (39%) had 1-, 3-, and 5-year death-rates of 12%, 36%, and 47%, respectively, vs 8%, 24%, and 36% for those with normal QTc (log-rank P = 0.03). In a multivariate Cox regression model that adjusted for age, gender, diabetes mellitus, myocardial infarction, presence and severity of CAD on angiography, left ventricular (LV) hypertrophy, LV ejection fraction (EF), and multiple other variables, QTc remained to be an independent predictor of survival (hazard ratio [HR]: 1.008, 95% confidence interval [CI]: 1.001-1.014, P = 0.016). Female gender, decreasing LVEF, and decreasing severity of CAD on angiography were independent predictors of prolonged QTc. Conclusions: QTc prolongation is an independent predictor of mortality in ESRD patients being evaluated for renal transplantation. The prognostic information gained from the QTc is additive to that provided by the LVEF and the severity of CAD.

AB - Background: Coronary artery disease (CAD) is the predominant cause of sudden cardiac death in the general population, and sudden cardiac death is the leading cause of mortality in end-stage renal disease (ESRD). Hypothesis: QT-interval prolongation is an independent prognosticator in ESRD. Methods: We reviewed clinical, electrocardiographic, stress test, and coronary angiography data on ESRD patients evaluated for transplantation at our institution between 2000 and 2004 who underwent coronary angiography. The QT interval was corrected for heart rate and QRS duration (QTc). All-cause mortality data were prospectively collected and verified against the Social Security Death Index database. Results: During 40 ± 28 months of follow-up, 132 of the 280 (47%) patients died prior to renal transplantation. Patients with a prolonged QTc (39%) had 1-, 3-, and 5-year death-rates of 12%, 36%, and 47%, respectively, vs 8%, 24%, and 36% for those with normal QTc (log-rank P = 0.03). In a multivariate Cox regression model that adjusted for age, gender, diabetes mellitus, myocardial infarction, presence and severity of CAD on angiography, left ventricular (LV) hypertrophy, LV ejection fraction (EF), and multiple other variables, QTc remained to be an independent predictor of survival (hazard ratio [HR]: 1.008, 95% confidence interval [CI]: 1.001-1.014, P = 0.016). Female gender, decreasing LVEF, and decreasing severity of CAD on angiography were independent predictors of prolonged QTc. Conclusions: QTc prolongation is an independent predictor of mortality in ESRD patients being evaluated for renal transplantation. The prognostic information gained from the QTc is additive to that provided by the LVEF and the severity of CAD.

UR - http://www.scopus.com/inward/record.url?scp=77953890765&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953890765&partnerID=8YFLogxK

U2 - 10.1002/clc.20768

DO - 10.1002/clc.20768

M3 - Article

C2 - 20556806

AN - SCOPUS:77953890765

VL - 33

SP - 361

EP - 366

JO - Clinical Cardiology

JF - Clinical Cardiology

SN - 0160-9289

IS - 6

ER -