Prolonged QT interval in ST-elevation myocardial infarction and mortality

Rivera-Fernández, Ricardo; Arias-Verdu, M. D.; García-Paredes, Teresa; Delgado-Rodrı́guez, Miguel; Arboleda-Sánchez, José Andrés; Aguilar-Alonso, Eduardo; Quesada-García, Guillermo; Vera-Almazán, A.

doi:10.2459/jcm.0000000000000015

Cited by 19 publications

(15 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is possible that the prompt reperfusion therapy in our patients with STEMI will influence the temporal evolution of QTc intervals and the best measuring time of QTc intervals will thus be different. One recent study reported that prolonged QTc interval of first ECG (prehospital or hospital admission) predicted in-hospital mortality in patients with STEMI 22 , which is consistent with our findings. Our study is the first study to evaluate the effects of serial QTc interval changes on the long term outcomes in patients with STEMI exclusively receiving primary PCI.…”

Section: Discussionsupporting

confidence: 92%

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

Lin¹,

Hsu²,

Wu³

et al. 2015

Int. J. Med. Sci.

View full text Add to dashboard Cite

Objectives: Heart-rate corrected QT (QTc) interval predicts cardiovascular mortality or all-cause mortality in the general population. Little is known about the best cut-off value of QTc interval for predicting clinical events in patients with ST-elevation myocardial infarction (STEMI).Methods: We enrolled 264 patients with STEMI who received measurement of QTc intervals at ER (QTc-ER), on day 2 (QTc-D2), and on day 3 (QTc-D3) of hospitalization. Clinical events, including all-cause death and readmission for heart failure, were followed for 2 years.Results: Prolonged QTc-ER, but not QTc-D2 or QTc-D3, well predicted clinical events with the best cut-off value of 445 ms. Patient with QTc-ER > 445 ms had lower left ventricular ejection fraction at baseline and at 6 months. Kaplan-Meier survival curves showed that the combination of QTc-ER > 445 ms and N-terminal pro-brain natriuretic peptide (NT-pro BNP) > 936 pg/mL was a strong predictor of clinical events (p<0.001). In multivariable Cox regression analysis, the independent predictors of death and heart failure were QTc-ER (p<0.001), log NT-proBNP (p<0.001), diabetes mellitus (p<0.001), history of stroke (p=0.001), and left ventricular end diastolic volume index (p<0.001).Conclusion: QTc-ER > 445 ms independently predicts clinical events in STEMI, providing incremental prognostic value to established clinical predictors and NT-proBNP.

show abstract

Section: Discussionsupporting

confidence: 92%

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

Lin¹,

Hsu²,

Wu³

et al. 2015

Int. J. Med. Sci.

View full text Add to dashboard Cite

show abstract

“…However, we have been able to confirm that, in a prognostic system using only 2 of the variables included in the previous study [30] (Killip and age), the discrimination is slightly inferior but continues to be a good discrimination (ROC area, 0.846) and that this is sufficient to be used in clinical practice. Furthermore, this new prognostic system is simpler and, therefore, easier to use, than the system, which includes QT interval and also easier to use than other systems habitually used, such as TIMI and GRACE [25][26][27].…”

Section: Discussionsupporting

confidence: 61%

“…Our group recently published a case-control study nested in a cohort [30], and as was stated in the introduction, the study centred on the evaluation of patients with prolonged QT interval and its prognostic implications in patients with AMI. The study also describes a new prognostic scale with 3 variables (Killip class, age, and prolonged QT), which has good discrimination (ROC area, 0.88).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of prognostic scale Thrombolysis In Myocardial Infarction and Killip. An ST-elevation myocardial infarction new scale

García-Paredes

Aguilar-Alonso²,

Arboleda-Sánchez

et al. 2014

The American Journal of Emergency Medicine

Self Cite

View full text Add to dashboard Cite

“…Therefore, measures that can effectively hinder the damage associated with heart failure are important. AMI is the predominant cause of myocardial infarction, and left ventricular remodelling (LVM) occurs at a later stage (3). LVM refers to the pathological changes in the immune activation state of the body caused by large amounts of cytokines secreted by myocardial cells, under the influence of injury, ventricular wall stress, oxidative stress and partial activation of the neuroendocrine system, which induces myocardial collagen deposition and changes in collagen type and collagen degradation (4).…”

Section: Introductionmentioning

confidence: 99%

Internal associations and dynamic expression of c-kit and nanog genes in ventricular remodelling induced by adriamycin

Liu

et al. 2016

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Abstract. The present study aimed to investigate the dynamic expression of the c-kit and nanog genes in rats with left ventricular remodelling induced by adriamycin (ADR), and explore its internal association and mechanism of action. Sprague-Dawley male rats were randomly divided into a normal control group and a heart failure model group. Heart failure was induced by a single intraperitoneal injection of ADR (4 mg/kg) weekly for six weeks. The normal control group was given the same amount of saline. At the eighth week, rat cardiac function was examined to demonstrate the formation of heart failure. The rat hearts were harvested frozen and sectioned, and the expression levels of the nanog and c-kit genes in the myocardial tissue samples were detected using immunohistochemistry, immunofluorescence and reverse transcription-polymerase chain reaction (RT-PCR). Hematoxylin and eosin staining demonstrated various pathological changes in the myocardial cells in the heart failure model group, whereas myocardial infarction was not observed in the normal control group. Immunohistochemistry and immunofluorescence demonstrated that nanog-positive cells were predominantly expressed in the vascular endothelium, with a few myocardial cells and stem cells in normal myocardium. The expression levels of c-kit and nanog in the myocardium of the rats with heart failure decreased significantly. c-kit-positive cells clustered together in the epicardium and its vicinity, and c-kit expression significantly decreased in the myocardium of rats with heart failure, as compared with normal rats. In both groups, some cells co-expressed both the c-kit and nanog genes. The RT-PCR results demonstrated that the expression levels of the two genes in the heart failure model group were significantly lower compared with those in the normal control group (P<0.05).In conclusion, the c-kit-and nanog-positive stem cells decreased in the myocardium of the rats with left ventricular remodelling induced by ADR. Their abnormal expression was significantly correlated with left ventricular remodelling, thereby indicating an internal association (influences of two indexes in the experimental group and control group) between them.

show abstract

Prolonged QT interval in ST-elevation myocardial infarction and mortality

Cited by 19 publications

References 31 publications

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

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

Evaluation of prognostic scale Thrombolysis In Myocardial Infarction and Killip. An ST-elevation myocardial infarction new scale

Internal associations and dynamic expression of c-kit and nanog genes in ventricular remodelling induced by adriamycin

Contact Info

Product

Resources

About