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Prolonged QTc interval predicts long-term mortality in cirrhosis: a propensity score matching analysis
Shuhong Li1, Xuwen Hao1, Simiao Liu1
1Department of Gastroenterology, Tianjin Nankai Hospital, Tianjin, China.
Insights
A prolonged corrected QT (QTc) interval over 440ms predicts mortality in cirrhosis patients. This finding aids in identifying individuals at high risk for all-cause mortality.
Area of Science:
- Cardiology
- Hepatology
- Clinical Medicine
Background:
- Prolonged corrected QT (QTc) interval is a key indicator of cirrhotic cardiomyopathy (CCM).
- QTc interval predicts mortality in cirrhosis patients, but cut-offs and applicable populations require clarification.
Purpose of the Study:
- To investigate the prognostic value of a prolonged QTc interval for mortality in cirrhosis patients.
- To identify independent predictors of 3-year mortality in cirrhosis.
Main Methods:
- 274 cirrhosis patients were analyzed.
- QTc interval > 440ms, calculated using the adjusted Fridericia's formula, was used for risk stratification.
- Cox regression, Kaplan-Meier survival analysis, and propensity score matching (PSM) were employed.
Main Results:
- A QTc interval > 440ms independently predicted mortality in the overall cohort (HR 2.532) and the PSM subset (HR 2.802).
- This prolonged QTc interval was also an independent predictor in patients ≤60 years and those with ascites.
Conclusions:
- A prolonged QTc interval (> 440ms) can identify cirrhosis patients at high risk of all-cause mortality.
- This biomarker may assist in clinical risk stratification for cirrhotic patients.
Background:
Prolonged corrected QT (QTc) interval is a hallmark of cirrhotic cardiomyopathy (CCM) and has been ascertained to predict mortality in cirrhosis. However, some critical issues remain to be addressed including unanimous cut-off, calculation approach and applicable population.
Methods:
A total of 274 patients with cirrhosis were included. The prolonged QTc interval over 440 ms according to adjusted Fridericia's formula was used to stratify enrolled subjects. Independent predictors of 3-year mortality were identified with Cox regression model. The Kaplan-Meier method was implemented to obtain survival curves. To reduce impact of selection bias and possible confounders, a propensity score matching (PSM) analysis was used.
Results:
QTc > 440 ms was an independent risk factor in the entire cohort and PSM subset (HR 2.532, 95% CI 1.431-4.480, p=.001; HR 2.802, 95% CI 1.171-6.701, p=.021, respectively). Subgroup analysis showed that QTc > 440 ms was an independent predictor in cirrhotics with age ≤60 years (HR = 1.02, p=.035) and in the presence of ascites (HR = 1.01, p=.008).
Conclusions:
The prolonged QTc interval might help to identify patients with high-risk of all-cause mortality.
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