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.
Bibliographical noteFunding 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.
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).
© 2020 The Korean Association of Internal Medicine.
All Science Journal Classification (ASJC) codes
- Internal Medicine