QT interval and short-term outcome in acute heart failure

Objective: To investigate the association of corrected QT (QTc) interval duration and short-term outcomes in patients with acute heart failure (AHF). Methods: We analyzed AHF patients enrolled in 11 Spanish emergency departments (ED) for whom an ECG with QTc measurement was available. Patients with...

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Authors: Miró i Andreu, Òscar, Aguiló, Oriol, Trullàs, Joan Carles, Gil Espinosa, Victor, Espinosa, Begoña, Jacob, Javier, Herrero Puente, Pablo, Tost, Josep, López-Grima, María Luisa, Comas, Pere, Bibiano, Carlos, Llauger, Lluís, Martín Mojarro, Enrique, López Díez, María Pilar, Nuñez, Julio, Rafique, Zubaid, Keene, Kelly R., Peacock, Frank, Lopez-Ayala, Pedro, Mueller, Christian, Montero Pérez-Barquero, Manuel, Mont Girbau, Lluís, Llorens Soriano, Pere, ICA-SEMES research investigators
Format: article
Status:Published version
Publication Date:2023
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/220743
Online Access:https://hdl.handle.net/2445/220743
Access Level:Open access
Keyword:Insuficiència cardíaca
Electrocardiografia
Mortalitat
Pronòstic mèdic
Urgències mèdiques
Heart failure
Electrocardiography
Mortality
Prognosis
Medical emergencies
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repository_id_str
spelling QT interval and short-term outcome in acute heart failureMiró i Andreu, ÒscarAguiló, OriolTrullàs, Joan CarlesGil Espinosa, VictorEspinosa, BegoñaJacob, JavierHerrero Puente, PabloTost, JosepLópez-Grima, María LuisaComas, PereBibiano, CarlosLlauger, LluísMartín Mojarro, EnriqueLópez Díez, María PilarNuñez, JulioRafique, ZubaidKeene, Kelly R.Peacock, FrankLopez-Ayala, PedroMueller, ChristianMontero Pérez-Barquero, ManuelMont Girbau, LluísLlorens Soriano, PereICA-SEMES research investigatorsInsuficiència cardíacaElectrocardiografiaMortalitatPronòstic mèdicUrgències mèdiquesHeart failureElectrocardiographyMortalityPrognosisMedical emergenciesObjective: To investigate the association of corrected QT (QTc) interval duration and short-term outcomes in patients with acute heart failure (AHF). Methods: We analyzed AHF patients enrolled in 11 Spanish emergency departments (ED) for whom an ECG with QTc measurement was available. Patients with pace-maker rhythm were excluded. Primary outcome was 30-day all-cause mortality and secondary outcomes were need of hospitalization, in-hospital mortality and prolonged hospitalization (> 7 days). Association between QTc and outcomes was explored by restricted cubic spline (RCS) curves. Results were expressed as odds ratios (OR) and 95%CI adjusted by patients baseline and decompensation characteristics, using a QTc = 450 ms as reference. Results: Of 1800 patients meeting entry criteria (median age 84 years (IQR = 77-89), 56% female), their median QTc was 453 ms (IQR = 422-483). The 30-day mortality was 9.7%, while need of hospitalization, in-hospital mortality and prolonged hospitalization were 77.8%, 9.0% and 50.0%, respectively. RCS curves found longer QTc was associated with 30-day mortality if > 561 ms, OR = 1.86 (1.00-3.45), and increased up to OR = 10.5 (2.25-49.1), for QTc = 674 ms. A similar pattern was observed for in-hospital mortality; OR = 2.64 (1.04-6.69), for QTc = 588 ms, and increasing up to OR = 8.02 (1.30-49.3), for QTc = 674 ms. Conversely, the need of hospitalization had a U-shaped relationship: being increased in patients with shorter QTc [OR = 1.45 (1.00-2.09) for QTc = 381 ms, OR = 5.88 (1.25-27.6) for the shortest QTc of 200 ms], and also increasing for prolonged QTc [OR = 1.06 (1.00-1.13), for QTc = 459 ms, and reaching OR = 2.15 (1.00-4.62) for QTc = 588 ms]. QTc was not associated with prolonged hospitalization. Conclusion: In ED AHF patients, initial QTc provides independent short-term prognostic information, with increasing QTc associated with increasing mortality, while both, shortened and prolonged QTc are associated with need of hospitalization.Springer Verlag2025202520232025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion12 p.application/pdfapplication/pdfhttps://hdl.handle.net/2445/220743Articles publicats en revistes (Medicina)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1007/s00392-023-02173-9Clinical Research In Cardiology, 2023, vol. 112, num.12, p. 1754-1765https://doi.org/10.1007/s00392-023-02173-9cc-by (c) Miró i Andreu, Òscar et al., 2023http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2207432026-05-29T05:05:01Z
dc.title.none.fl_str_mv QT interval and short-term outcome in acute heart failure
title QT interval and short-term outcome in acute heart failure
spellingShingle QT interval and short-term outcome in acute heart failure
Miró i Andreu, Òscar
Insuficiència cardíaca
Electrocardiografia
Mortalitat
Pronòstic mèdic
Urgències mèdiques
Heart failure
Electrocardiography
Mortality
Prognosis
Medical emergencies
title_short QT interval and short-term outcome in acute heart failure
title_full QT interval and short-term outcome in acute heart failure
title_fullStr QT interval and short-term outcome in acute heart failure
title_full_unstemmed QT interval and short-term outcome in acute heart failure
title_sort QT interval and short-term outcome in acute heart failure
dc.creator.none.fl_str_mv Miró i Andreu, Òscar
Aguiló, Oriol
Trullàs, Joan Carles
Gil Espinosa, Victor
Espinosa, Begoña
Jacob, Javier
Herrero Puente, Pablo
Tost, Josep
López-Grima, María Luisa
Comas, Pere
Bibiano, Carlos
Llauger, Lluís
Martín Mojarro, Enrique
López Díez, María Pilar
Nuñez, Julio
Rafique, Zubaid
Keene, Kelly R.
Peacock, Frank
Lopez-Ayala, Pedro
Mueller, Christian
Montero Pérez-Barquero, Manuel
Mont Girbau, Lluís
Llorens Soriano, Pere
ICA-SEMES research investigators
author Miró i Andreu, Òscar
author_facet Miró i Andreu, Òscar
Aguiló, Oriol
Trullàs, Joan Carles
Gil Espinosa, Victor
Espinosa, Begoña
Jacob, Javier
Herrero Puente, Pablo
Tost, Josep
López-Grima, María Luisa
Comas, Pere
Bibiano, Carlos
Llauger, Lluís
Martín Mojarro, Enrique
López Díez, María Pilar
Nuñez, Julio
Rafique, Zubaid
Keene, Kelly R.
Peacock, Frank
Lopez-Ayala, Pedro
Mueller, Christian
Montero Pérez-Barquero, Manuel
Mont Girbau, Lluís
Llorens Soriano, Pere
ICA-SEMES research investigators
author_role author
author2 Aguiló, Oriol
Trullàs, Joan Carles
Gil Espinosa, Victor
Espinosa, Begoña
Jacob, Javier
Herrero Puente, Pablo
Tost, Josep
López-Grima, María Luisa
Comas, Pere
Bibiano, Carlos
Llauger, Lluís
Martín Mojarro, Enrique
López Díez, María Pilar
Nuñez, Julio
Rafique, Zubaid
Keene, Kelly R.
Peacock, Frank
Lopez-Ayala, Pedro
Mueller, Christian
Montero Pérez-Barquero, Manuel
Mont Girbau, Lluís
Llorens Soriano, Pere
ICA-SEMES research investigators
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Insuficiència cardíaca
Electrocardiografia
Mortalitat
Pronòstic mèdic
Urgències mèdiques
Heart failure
Electrocardiography
Mortality
Prognosis
Medical emergencies
topic Insuficiència cardíaca
Electrocardiografia
Mortalitat
Pronòstic mèdic
Urgències mèdiques
Heart failure
Electrocardiography
Mortality
Prognosis
Medical emergencies
description Objective: To investigate the association of corrected QT (QTc) interval duration and short-term outcomes in patients with acute heart failure (AHF). Methods: We analyzed AHF patients enrolled in 11 Spanish emergency departments (ED) for whom an ECG with QTc measurement was available. Patients with pace-maker rhythm were excluded. Primary outcome was 30-day all-cause mortality and secondary outcomes were need of hospitalization, in-hospital mortality and prolonged hospitalization (> 7 days). Association between QTc and outcomes was explored by restricted cubic spline (RCS) curves. Results were expressed as odds ratios (OR) and 95%CI adjusted by patients baseline and decompensation characteristics, using a QTc = 450 ms as reference. Results: Of 1800 patients meeting entry criteria (median age 84 years (IQR = 77-89), 56% female), their median QTc was 453 ms (IQR = 422-483). The 30-day mortality was 9.7%, while need of hospitalization, in-hospital mortality and prolonged hospitalization were 77.8%, 9.0% and 50.0%, respectively. RCS curves found longer QTc was associated with 30-day mortality if > 561 ms, OR = 1.86 (1.00-3.45), and increased up to OR = 10.5 (2.25-49.1), for QTc = 674 ms. A similar pattern was observed for in-hospital mortality; OR = 2.64 (1.04-6.69), for QTc = 588 ms, and increasing up to OR = 8.02 (1.30-49.3), for QTc = 674 ms. Conversely, the need of hospitalization had a U-shaped relationship: being increased in patients with shorter QTc [OR = 1.45 (1.00-2.09) for QTc = 381 ms, OR = 5.88 (1.25-27.6) for the shortest QTc of 200 ms], and also increasing for prolonged QTc [OR = 1.06 (1.00-1.13), for QTc = 459 ms, and reaching OR = 2.15 (1.00-4.62) for QTc = 588 ms]. QTc was not associated with prolonged hospitalization. Conclusion: In ED AHF patients, initial QTc provides independent short-term prognostic information, with increasing QTc associated with increasing mortality, while both, shortened and prolonged QTc are associated with need of hospitalization.
publishDate 2023
dc.date.none.fl_str_mv 2023
2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/220743
url https://hdl.handle.net/2445/220743
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1007/s00392-023-02173-9
Clinical Research In Cardiology, 2023, vol. 112, num.12, p. 1754-1765
https://doi.org/10.1007/s00392-023-02173-9
dc.rights.none.fl_str_mv cc-by (c) Miró i Andreu, Òscar et al., 2023
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Miró i Andreu, Òscar et al., 2023
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 12 p.
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Springer Verlag
publisher.none.fl_str_mv Springer Verlag
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869410813795631104
score 15,81155

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