Corrected QT interval: a prognostic marker in patients with non-ST-segment elevation acute coronary syndrome?

Over many decades, the corrected QT (QTc) has become an established clinical tool for the prediction of sudden cardiac death and life-threatening ventricular arrhythmias and for monitoring adverse effects of pharmacological agents capable of triggering serious ventricular arrhythmias mainly associated with QTc prolongation. Recent evidence also suggests that QTc prolongation is a predictor of poor clinical outcome in patients with coronary artery disease, particularly in the setting of the acute coronary syndrome. Indeed, in the past few years, studies assessing the predictive role of QTc measurements have provided important information in this regard and suggest a potential role of the QTc in patient risk stratification. The incorporation of biomarkers of myocardial damage (ie cardiac troponins), clinical risk scores, and other biochemical and angiographic markers in the past two decades has considerably improved the risk stratification of patients presenting with acute coronary syndrome, but further refinement of our prognostic armamentarium is still required. This article reviews the information available regarding the potential role of the QTc as a marker of increased risk in patients with acute presentations of coronary artery disease.