Detailed Information on Publication Record
2018
Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction
CUPA, J., I. STREBEL, P. BADERTSCHER, R. ABACHERLI, R. TWERENBOLD et. al.Basic information
Original name
Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction
Authors
CUPA, J. (756 Switzerland), I. STREBEL (756 Switzerland), P. BADERTSCHER (756 Switzerland), R. ABACHERLI (756 Switzerland), R. TWERENBOLD (756 Switzerland), L. SCHUMACHER (756 Switzerland), J. BOEDDINGHAUS (756 Switzerland), T. NESTELBERGER (756 Switzerland), P. MAECHLER (756 Switzerland), N. KOZHUHAROV (756 Switzerland), M.R. GIMENEZ (756 Switzerland), K. WILDI (756 Switzerland), J.D. de LAVALLAZ (756 Switzerland), Z. SABTI (756 Switzerland), L. SAZGARY (756 Switzerland), C. PUELACHER (756 Switzerland), D. MUELLER (756 Switzerland), C. BIANCI (756 Switzerland), O. MIRO (756 Switzerland), C. FUENZALIDA (724 Spain), S. CALDERON (724 Spain), F.J. MARTIN-SANCHEZ (724 Spain), S.L. IGLESIAS (724 Spain), B. MORAWIEE (616 Poland), D. KAWECKR (616 Poland), Jiří PAŘENICA (203 Czech Republic, belonging to the institution), D.I. KELLER (756 Switzerland), N. GEIGY (756 Switzerland), S. OSSWALD (756 Switzerland), C. MUELLER (756 Switzerland) and T. REICHLIN (756 Switzerland, guarantor)
Edition
CARDIOLOGY JOURNAL, GDANSK, VIA MEDICA, 2018, 1897-5593
Other information
Language
English
Type of outcome
Článek v odborném periodiku
Field of Study
30201 Cardiac and Cardiovascular systems
Country of publisher
Poland
Confidentiality degree
není předmětem státního či obchodního tajemství
Impact factor
Impact factor: 1.743
RIV identification code
RIV/00216224:14110/18:00104901
Organization unit
Faculty of Medicine
UT WoS
000449351400009
Keywords in English
QRS duration; QTc interval; chest pain
Tags
International impact, Reviewed
Změněno: 9/2/2019 22:05, Soňa Böhmová
Abstract
V originále
Background: While prolongation of QRS duration and QTc interval during acute myocardial infarction (AMI) has been reported in animals, limited data is available for these readily available electrocardiography (ECG) markers in humans. Methods: Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected AMI in a prospective diagnostic multicentre study were prospectively assessed, Digital 12-lead ECGs were recorded at presentation. QRS duration and QTc interval were automatically calculated in a blinded fashion. Final diagnosis was adjudicated by two independent cardiologists. The prognostic endpoint was all-cause mortality during 24 months of follow-up. Results: Among 4042 patients, AMI was the final diagnosis in 19% of patients. Median QRS duration and median QTc interval were significantly greater in patients with AMI compared to those with other final diagnoses (98 ms (IQR 88-108] vs. 94 ms [IQR 86-102] and 436 ms [IQR 414-462] vs. 425 ms [IQR 407-445], p < 0.001 for both comparisons). The diagnostic value of both ECG signatures however was only modest (AUC 0.56 and 0.60). Cumulative mortality rates after 2 years were 15.9% vs. 5.6% in patients with a QRS > 120 ms compared to a QRS duration <= 120 ms (p < 0.001), and 11.4% vs. 4.3% in patients with a QTc > 440 ms compared to a QRS duration <= 440 ms (p < 0.001). After adjustment for age and important ECG and clinical parameters, the QTc interval but not QRS duration remained an independent predictor of mortality. Conclusions: Prolongation of QRS duration > 120 ms and QTc interval > 440 ms predict mortality in patients with suspected AMI, but do not add diagnostic value.