PMID- 24922196
OWN - NLM
STAT- MEDLINE
DCOM- 20160912
LR  - 20151126
IS  - 1558-2035 (Electronic)
IS  - 1558-2027 (Linking)
VI  - 17
IP  - 1
DP  - 2016 Jan
TI  - Prolonged QT interval in ST-elevation myocardial infarction and mortality: new 
      prognostic scale with QT, Killip and age.
PG  - 11-9
LID - 10.2459/JCM.0000000000000015 [doi]
AB  - AIMS: To analyze the relation between prolonged QT interval and mortality in 
      patients with ST-elevation myocardial infarction and complementarity with Killip, 
      Thrombolysis in Myocardial Infarction (TIMI) and Acute Physiology and Chronic 
      Health Evaluation-II (APACHE-II) scales. METHODS: A nested cohort case-control 
      study was conducted in a Spanish hospital. The cohort consisted of patients with 
      ST-elevation myocardial infarction admitted between 2008 and 2010 (n = 524). The 
      cases were the patients who died (n = 38) and the controls (n = 81) were a random 
      sample of those who survived (one of every six). RESULTS: The corrected QT (QTc) 
      interval of first ECG (prehospital-or-hospital admission) was prolonged in 18 of 
      the 35 patients who died (51.4%) and in 12 of the controls (16.7%; P < 0.001). 
      APACHE-II, TIMI and Killip scores were higher in the patients who had died 
      (P < 0.001). Mortality with prolonged QTc (19.3%) was 20%, and 4.5% were with 
      normal QTc (80.7%; P < 0.001).Logistic regression showed a relation between 
      mortality with prolonged QTc and TIMI [odds ratio (OR) 3.57(1.16-10.97)]. A 
      second model was constructed with APACHE-II and prolonged QTc [OR 
      6.47(1.77-23.59)]; receiver operating characteristic (ROC) curve area 
      [0.92(0.87-0.97)], and individually, for APACHE-II was 0.88 (0.81-0.95). A new 
      score was constructed: QTc (not prolonged: 0 points, prolonged: 7 points), age 
      (<65 years: 0 points, 65-74 years: 6 points, >/=75 years: 9 points), Killip (I: 0 
      points, II-III: 4 points, IV: 17 points). ROC area: 0.88. CONCLUSIONS: Hospital 
      mortality was higher with prolonged QTc at prehospital-or-hospital admission, 
      given equal Killip, TIMI and APACHE values. Discrimination of Killip, TIMI and 
      APACHE values can be improved with prolonged QTc. Discrimination of a model 
      including Killip, age and prolonged QTc is quite good. We have made a new simple 
      prognostic scale with these variables.
FAU - Rivera-Fernandez, Ricardo
AU  - Rivera-Fernandez R
AD  - aIntensive Care Unit bCoronary Care Unit, Hospital Carlos Haya, Malaga cCIBERESP, 
      Preventive Medicine and Public Health, University of Jaen dIntensive Care Unit, 
      Hospital Infanta Margarita, Cabra (Cordoba), Spain.
FAU - Arias-Verdu, Maria Dolores
AU  - Arias-Verdu MD
FAU - Garcia-Paredes, Teresa
AU  - Garcia-Paredes T
FAU - Delgado-Rodriguez, Miguel
AU  - Delgado-Rodriguez M
FAU - Arboleda-Sanchez, Jose Andres
AU  - Arboleda-Sanchez JA
FAU - Aguilar-Alonso, Eduardo
AU  - Aguilar-Alonso E
FAU - Quesada-Garcia, Guillermo
AU  - Quesada-Garcia G
FAU - Vera-Almazan, Antonio
AU  - Vera-Almazan A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Cardiovasc Med (Hagerstown)
JT  - Journal of cardiovascular medicine (Hagerstown, Md.)
JID - 101259752
SB  - IM
MH  - APACHE
MH  - Acute Coronary Syndrome/complications/diagnosis/mortality
MH  - Aged
MH  - Aged, 80 and over
MH  - Case-Control Studies
MH  - Electrocardiography
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Long QT Syndrome/*complications/diagnosis/mortality
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*complications/diagnosis/mortality
MH  - Prognosis
MH  - Risk Assessment/methods
MH  - Severity of Illness Index
MH  - Spain/epidemiology
EDAT- 2014/06/13 06:00
MHDA- 2016/09/13 06:00
CRDT- 2014/06/13 06:00
PHST- 2014/06/13 06:00 [entrez]
PHST- 2014/06/13 06:00 [pubmed]
PHST- 2016/09/13 06:00 [medline]
AID - 10.2459/JCM.0000000000000015 [doi]
PST - ppublish
SO  - J Cardiovasc Med (Hagerstown). 2016 Jan;17(1):11-9. doi: 
      10.2459/JCM.0000000000000015.