J-curve relationship between corrected QT interval and mortality in acute heart failure patients

Chan Soon Park; Hyun Jai Cho; Eue Keun Choi; Sang Eun Lee; Min Seok Kim; Jae Joong Kim; Jin Oh Choi; Eun Seok Jeon; Kyung Kuk Hwang; Shung Chull Chae; Sang Hong Baek; Seok Min Kang; Byungsu Yoo; Dong Ju Choi; Youngkeun Ahn; Kye Hoon Kim; Myeong Chan Cho; Byung Hee Oh; Hae Young Lee

doi:10.3904/kjim.2019.030

J-curve relationship between corrected QT interval and mortality in acute heart failure patients

Chan Soon Park, Hyun Jai Cho, Eue Keun Choi, Sang Eun Lee, Min Seok Kim, Jae Joong Kim, Jin Oh Choi, Eun Seok Jeon, Kyung Kuk Hwang, Shung Chull Chae, Sang Hong Baek, Seok Min Kang, Byungsu Yoo, Dong Ju Choi, Youngkeun Ahn, Kye Hoon Kim, Myeong Chan Cho, Byung Hee Oh, Hae Young Lee

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Background/Aims: This study investigated the prognostic power of corrected QT (QTc) interval in patients with acute heart failure (AHF) according to sex. Methods: We analyzed multicenter Korean Acute Heart Failure registry with patients with AHF admitted from 2011 to 2014. Among them, we analyzed 4,990 patients who were followed up to 5 years. Regarding QTc interval based on 12 lead electrocardiogram, patients were classified into quartiles according to sex. Results: During follow-up with median 43.7 months, 2,243 (44.9%) patients died. The relationship between corrected QT interval and all-cause mortality followed a J-curve relationship. In Kaplan-Meier analysis, both sex had lowest mortality in the second QTc quartile. There were significant prognostic differences between the second and the fourth quartiles in male (log-rank p = 0.002), but not in female (log-rank p = 0.338). After adjusting covariates, the third (hazard ratio [HR], 1.185; 95% confidence interval [CI], 1.001 to 1.404; p = 0.049) and the fourth (HR, 1.404; 95% CI, 1.091 to 1.535; p = 0.003) quartiles demonstrated increased risk of mortality compared to the second quartile in male. In female, however, there was no significant difference across quartiles. QTc interval was associated with 5-year all-cause mortality in J-shape with nadir of 440 to 450 ms in male and 470 to 480 ms in fe-male. Conclusions: QTc interval was an independent predictor of overall death in male, but its significance decreased in female. The relationship between QTc interval and all-cause mortality was J-shaped in both sex.

Original language	English
Pages (from-to)	1371-1384
Number of pages	14
Journal	Korean Journal of Internal Medicine
Volume	35
Issue number	6
DOIs	https://doi.org/10.3904/kjim.2019.030
Publication status	Published - 2020

Bibliographical note

Funding Information:
This work was supported by Research of Korea Centers for Disease Control and Prevention (2010-E63003-00, 2011-E63002-00, 2012-E63005-00, and 2013-E63003-00). The KorAHF Registry was conducted from 10 tertia-ry medical centers: Seoul National University Hospi-tal, Seoul, Korea; Sungkyunkwan University College of Medicine, Seoul, Korea; University of Ulsan College of Medicine, Seoul, Korea; Chungbuk National University College of Medicine, Cheongju, Korea; Kyungpook National University College of Medicine, Daegu, Ko-rea; The Catholic University of Korea, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Yonsei University Wonju College of Medicine, Wonju, Korea; Seoul National University Bundang Hospital, Seongnam, Korea; Heart Research Center of Chonnam National University, Gwangju, Korea.

Funding Information:
This work was supported by Research of Korea Centers for Disease Control and Prevention (2010-E63003-00, 2011-E63002-00, 2012-E63005-00, and 2013-E63003-00).

Publisher Copyright:
© 2020 The Korean Association of Internal Medicine.

All Science Journal Classification (ASJC) codes

Internal Medicine

Access to Document

10.3904/kjim.2019.030

Cite this

Park, C. S., Cho, H. J., Choi, E. K., Lee, S. E., Kim, M. S., Kim, J. J., Choi, J. O., Jeon, E. S., Hwang, K. K., Chae, S. C., Baek, S. H., Kang, S. M., Yoo, B., Choi, D. J., Ahn, Y., Kim, K. H., Cho, M. C., Oh, B. H., & Lee, H. Y. (2020). J-curve relationship between corrected QT interval and mortality in acute heart failure patients. Korean Journal of Internal Medicine, 35(6), 1371-1384. https://doi.org/10.3904/kjim.2019.030

@article{8ae6aab9cfd342568def79d428636ffa,

title = "J-curve relationship between corrected QT interval and mortality in acute heart failure patients",

abstract = "Background/Aims: This study investigated the prognostic power of corrected QT (QTc) interval in patients with acute heart failure (AHF) according to sex. Methods: We analyzed multicenter Korean Acute Heart Failure registry with patients with AHF admitted from 2011 to 2014. Among them, we analyzed 4,990 patients who were followed up to 5 years. Regarding QTc interval based on 12 lead electrocardiogram, patients were classified into quartiles according to sex. Results: During follow-up with median 43.7 months, 2,243 (44.9%) patients died. The relationship between corrected QT interval and all-cause mortality followed a J-curve relationship. In Kaplan-Meier analysis, both sex had lowest mortality in the second QTc quartile. There were significant prognostic differences between the second and the fourth quartiles in male (log-rank p = 0.002), but not in female (log-rank p = 0.338). After adjusting covariates, the third (hazard ratio [HR], 1.185; 95% confidence interval [CI], 1.001 to 1.404; p = 0.049) and the fourth (HR, 1.404; 95% CI, 1.091 to 1.535; p = 0.003) quartiles demonstrated increased risk of mortality compared to the second quartile in male. In female, however, there was no significant difference across quartiles. QTc interval was associated with 5-year all-cause mortality in J-shape with nadir of 440 to 450 ms in male and 470 to 480 ms in fe-male. Conclusions: QTc interval was an independent predictor of overall death in male, but its significance decreased in female. The relationship between QTc interval and all-cause mortality was J-shaped in both sex.",

author = "Park, {Chan Soon} and Cho, {Hyun Jai} and Choi, {Eue Keun} and Lee, {Sang Eun} and Kim, {Min Seok} and Kim, {Jae Joong} and Choi, {Jin Oh} and Jeon, {Eun Seok} and Hwang, {Kyung Kuk} and Chae, {Shung Chull} and Baek, {Sang Hong} and Kang, {Seok Min} and Byungsu Yoo and Choi, {Dong Ju} and Youngkeun Ahn and Kim, {Kye Hoon} and Cho, {Myeong Chan} and Oh, {Byung Hee} and Lee, {Hae Young}",

note = "Funding Information: This work was supported by Research of Korea Centers for Disease Control and Prevention (2010-E63003-00, 2011-E63002-00, 2012-E63005-00, and 2013-E63003-00). The KorAHF Registry was conducted from 10 tertia-ry medical centers: Seoul National University Hospi-tal, Seoul, Korea; Sungkyunkwan University College of Medicine, Seoul, Korea; University of Ulsan College of Medicine, Seoul, Korea; Chungbuk National University College of Medicine, Cheongju, Korea; Kyungpook National University College of Medicine, Daegu, Ko-rea; The Catholic University of Korea, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Yonsei University Wonju College of Medicine, Wonju, Korea; Seoul National University Bundang Hospital, Seongnam, Korea; Heart Research Center of Chonnam National University, Gwangju, Korea. Funding Information: This work was supported by Research of Korea Centers for Disease Control and Prevention (2010-E63003-00, 2011-E63002-00, 2012-E63005-00, and 2013-E63003-00). Publisher Copyright: {\textcopyright} 2020 The Korean Association of Internal Medicine.",

year = "2020",

doi = "10.3904/kjim.2019.030",

language = "English",

volume = "35",

pages = "1371--1384",

journal = "Korean Journal of Internal Medicine",

issn = "1226-3303",

publisher = "Korean Association of Internal Medicine",

number = "6",

}

Park, CS, Cho, HJ, Choi, EK, Lee, SE, Kim, MS, Kim, JJ, Choi, JO, Jeon, ES, Hwang, KK, Chae, SC, Baek, SH, Kang, SM , Yoo, B, Choi, DJ, Ahn, Y, Kim, KH, Cho, MC, Oh, BH & Lee, HY 2020, 'J-curve relationship between corrected QT interval and mortality in acute heart failure patients', Korean Journal of Internal Medicine, vol. 35, no. 6, pp. 1371-1384. https://doi.org/10.3904/kjim.2019.030

TY - JOUR

T1 - J-curve relationship between corrected QT interval and mortality in acute heart failure patients

AU - Park, Chan Soon

AU - Cho, Hyun Jai

AU - Choi, Eue Keun

AU - Lee, Sang Eun

AU - Kim, Min Seok

AU - Kim, Jae Joong

AU - Choi, Jin Oh

AU - Jeon, Eun Seok

AU - Hwang, Kyung Kuk

AU - Chae, Shung Chull

AU - Baek, Sang Hong

AU - Kang, Seok Min

AU - Yoo, Byungsu

AU - Choi, Dong Ju

AU - Ahn, Youngkeun

AU - Kim, Kye Hoon

AU - Cho, Myeong Chan

AU - Oh, Byung Hee

AU - Lee, Hae Young

N1 - Funding Information: This work was supported by Research of Korea Centers for Disease Control and Prevention (2010-E63003-00, 2011-E63002-00, 2012-E63005-00, and 2013-E63003-00). The KorAHF Registry was conducted from 10 tertia-ry medical centers: Seoul National University Hospi-tal, Seoul, Korea; Sungkyunkwan University College of Medicine, Seoul, Korea; University of Ulsan College of Medicine, Seoul, Korea; Chungbuk National University College of Medicine, Cheongju, Korea; Kyungpook National University College of Medicine, Daegu, Ko-rea; The Catholic University of Korea, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Yonsei University Wonju College of Medicine, Wonju, Korea; Seoul National University Bundang Hospital, Seongnam, Korea; Heart Research Center of Chonnam National University, Gwangju, Korea. Funding Information: This work was supported by Research of Korea Centers for Disease Control and Prevention (2010-E63003-00, 2011-E63002-00, 2012-E63005-00, and 2013-E63003-00). Publisher Copyright: © 2020 The Korean Association of Internal Medicine.

PY - 2020

Y1 - 2020

N2 - Background/Aims: This study investigated the prognostic power of corrected QT (QTc) interval in patients with acute heart failure (AHF) according to sex. Methods: We analyzed multicenter Korean Acute Heart Failure registry with patients with AHF admitted from 2011 to 2014. Among them, we analyzed 4,990 patients who were followed up to 5 years. Regarding QTc interval based on 12 lead electrocardiogram, patients were classified into quartiles according to sex. Results: During follow-up with median 43.7 months, 2,243 (44.9%) patients died. The relationship between corrected QT interval and all-cause mortality followed a J-curve relationship. In Kaplan-Meier analysis, both sex had lowest mortality in the second QTc quartile. There were significant prognostic differences between the second and the fourth quartiles in male (log-rank p = 0.002), but not in female (log-rank p = 0.338). After adjusting covariates, the third (hazard ratio [HR], 1.185; 95% confidence interval [CI], 1.001 to 1.404; p = 0.049) and the fourth (HR, 1.404; 95% CI, 1.091 to 1.535; p = 0.003) quartiles demonstrated increased risk of mortality compared to the second quartile in male. In female, however, there was no significant difference across quartiles. QTc interval was associated with 5-year all-cause mortality in J-shape with nadir of 440 to 450 ms in male and 470 to 480 ms in fe-male. Conclusions: QTc interval was an independent predictor of overall death in male, but its significance decreased in female. The relationship between QTc interval and all-cause mortality was J-shaped in both sex.

AB - Background/Aims: This study investigated the prognostic power of corrected QT (QTc) interval in patients with acute heart failure (AHF) according to sex. Methods: We analyzed multicenter Korean Acute Heart Failure registry with patients with AHF admitted from 2011 to 2014. Among them, we analyzed 4,990 patients who were followed up to 5 years. Regarding QTc interval based on 12 lead electrocardiogram, patients were classified into quartiles according to sex. Results: During follow-up with median 43.7 months, 2,243 (44.9%) patients died. The relationship between corrected QT interval and all-cause mortality followed a J-curve relationship. In Kaplan-Meier analysis, both sex had lowest mortality in the second QTc quartile. There were significant prognostic differences between the second and the fourth quartiles in male (log-rank p = 0.002), but not in female (log-rank p = 0.338). After adjusting covariates, the third (hazard ratio [HR], 1.185; 95% confidence interval [CI], 1.001 to 1.404; p = 0.049) and the fourth (HR, 1.404; 95% CI, 1.091 to 1.535; p = 0.003) quartiles demonstrated increased risk of mortality compared to the second quartile in male. In female, however, there was no significant difference across quartiles. QTc interval was associated with 5-year all-cause mortality in J-shape with nadir of 440 to 450 ms in male and 470 to 480 ms in fe-male. Conclusions: QTc interval was an independent predictor of overall death in male, but its significance decreased in female. The relationship between QTc interval and all-cause mortality was J-shaped in both sex.

UR - http://www.scopus.com/inward/record.url?scp=85095413891&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85095413891&partnerID=8YFLogxK

U2 - 10.3904/kjim.2019.030

DO - 10.3904/kjim.2019.030

M3 - Article

C2 - 32380800

AN - SCOPUS:85095413891

SN - 1226-3303

VL - 35

SP - 1371

EP - 1384

JO - Korean Journal of Internal Medicine

JF - Korean Journal of Internal Medicine

IS - 6

ER -

J-curve relationship between corrected QT interval and mortality in acute heart failure patients

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

Access to Document

Other files and links

Fingerprint

Cite this