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QT interval Independently Predicts Mortality and Heart Failure in Patients with ST-Elevation Myocardial Infarction

Jeng-Feng Lin1, Shun-Yi Hsu1, Semon Wu2

  • 11. Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; ; 2. School of Medicine, Tzu Chi University, Hualien, Taiwan;

International Journal of Medical Sciences
|December 15, 2015
PubMed

Insights

The heart-rate corrected QT (QTc) interval measured at emergency room (ER) admission, specifically a QTc-ER greater than 445 ms, predicts clinical events in ST-elevation myocardial infarction (STEMI) patients. This finding offers valuable prognostic information beyond established markers.

Area of Science:

  • Cardiology
  • Clinical Electrophysiology

Background:

  • The heart-rate corrected QT (QTc) interval is a known predictor of mortality in the general population.
  • Optimal QTc interval cut-off values for predicting clinical events in ST-elevation myocardial infarction (STEMI) patients remain unclear.

Purpose of the Study:

  • To determine the best QTc interval cut-off value for predicting clinical events in STEMI patients.
  • To assess the prognostic value of QTc interval measurements at different time points during hospitalization.

Main Methods:

  • 264 STEMI patients had QTc intervals measured at ER (QTc-ER), day 2 (QTc-D2), and day 3 (QTc-D3).
  • Clinical events (all-cause death, heart failure readmission) were tracked for 2 years.

Main Results:

  • A QTc-ER > 445 ms was the best predictor of clinical events, unlike QTc-D2 or QTc-D3.
  • Patients with QTc-ER > 445 ms had reduced left ventricular ejection fraction.
  • Combined QTc-ER > 445 ms and elevated NT-proBNP significantly predicted events (p<0.001).
  • Independent predictors of death/heart failure included QTc-ER, NT-proBNP, diabetes, stroke history, and LV end-diastolic volume index.

Conclusions:

  • QTc-ER > 445 ms independently predicts clinical events in STEMI patients.
  • This measurement provides additional prognostic value beyond existing clinical predictors and NT-proBNP.
Abstract

Keywords:
QT intervalacute myocardial infarctionbrain natriuretic peptideleft ventricular remodeling.

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