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Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction

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Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction. / Cupa, Janosch; Strebel, Ivo; Badertscher, Patrick; Abächerli, Roger; Twerenbold, Raphael; Schumacher, Lukas; Boeddinghaus, Jasper; Nestelberger, Thomas; Maechler, Patrick; Kozhuharov, Nikola; Giménez, Maria Rubini; Wildi, Karin; du Fay de Lavallaz, Jeanne; Sabti, Zaid; Sazgary, Lorraine; Puelacher, Christian; Mueller, Deborah; Bianci, Chiara; Miró, Òscar; Fuenzalida, Carolina; Calderón, Sofia; Martín-Sánchez, F Javier; Iglesias, Sergio Lopez; Morawiec, Beata; Kawecki, Damian; Parenica, Jiri; Keller, Dagmar I; Geigy, Nicolas; Osswald, Stefan; Mueller, Christian; Reichlin, Tobias.

in: CARDIOL J, Jahrgang 25, Nr. 5, 2018, S. 601-610.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Cupa, J, Strebel, I, Badertscher, P, Abächerli, R, Twerenbold, R, Schumacher, L, Boeddinghaus, J, Nestelberger, T, Maechler, P, Kozhuharov, N, Giménez, MR, Wildi, K, du Fay de Lavallaz, J, Sabti, Z, Sazgary, L, Puelacher, C, Mueller, D, Bianci, C, Miró, Ò, Fuenzalida, C, Calderón, S, Martín-Sánchez, FJ, Iglesias, SL, Morawiec, B, Kawecki, D, Parenica, J, Keller, DI, Geigy, N, Osswald, S, Mueller, C & Reichlin, T 2018, 'Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction', CARDIOL J, Jg. 25, Nr. 5, S. 601-610. https://doi.org/10.5603/CJ.a2018.0033

APA

Cupa, J., Strebel, I., Badertscher, P., Abächerli, R., Twerenbold, R., Schumacher, L., Boeddinghaus, J., Nestelberger, T., Maechler, P., Kozhuharov, N., Giménez, M. R., Wildi, K., du Fay de Lavallaz, J., Sabti, Z., Sazgary, L., Puelacher, C., Mueller, D., Bianci, C., Miró, Ò., ... Reichlin, T. (2018). Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction. CARDIOL J, 25(5), 601-610. https://doi.org/10.5603/CJ.a2018.0033

Vancouver

Cupa J, Strebel I, Badertscher P, Abächerli R, Twerenbold R, Schumacher L et al. Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction. CARDIOL J. 2018;25(5):601-610. https://doi.org/10.5603/CJ.a2018.0033

Bibtex

@article{5c98f539c3bd4fa8ae746bb5edc8db11,
title = "Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction",
abstract = "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.",
keywords = "Aged, Aged, 80 and over, Cause of Death/trends, Electrocardiography, Europe/epidemiology, Female, Follow-Up Studies, Heart Rate/physiology, Humans, Male, Middle Aged, Myocardial Infarction/diagnosis, Prognosis, Prospective Studies, Risk Factors",
author = "Janosch Cupa and Ivo Strebel and Patrick Badertscher and Roger Ab{\"a}cherli and Raphael Twerenbold and Lukas Schumacher and Jasper Boeddinghaus and Thomas Nestelberger and Patrick Maechler and Nikola Kozhuharov and Gim{\'e}nez, {Maria Rubini} and Karin Wildi and {du Fay de Lavallaz}, Jeanne and Zaid Sabti and Lorraine Sazgary and Christian Puelacher and Deborah Mueller and Chiara Bianci and {\`O}scar Mir{\'o} and Carolina Fuenzalida and Sofia Calder{\'o}n and Mart{\'i}n-S{\'a}nchez, {F Javier} and Iglesias, {Sergio Lopez} and Beata Morawiec and Damian Kawecki and Jiri Parenica and Keller, {Dagmar I} and Nicolas Geigy and Stefan Osswald and Christian Mueller and Tobias Reichlin",
year = "2018",
doi = "10.5603/CJ.a2018.0033",
language = "English",
volume = "25",
pages = "601--610",
journal = "CARDIOL J",
issn = "1897-5593",
publisher = "Via Medica",
number = "5",

}

RIS

TY - JOUR

T1 - Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction

AU - Cupa, Janosch

AU - Strebel, Ivo

AU - Badertscher, Patrick

AU - Abächerli, Roger

AU - Twerenbold, Raphael

AU - Schumacher, Lukas

AU - Boeddinghaus, Jasper

AU - Nestelberger, Thomas

AU - Maechler, Patrick

AU - Kozhuharov, Nikola

AU - Giménez, Maria Rubini

AU - Wildi, Karin

AU - du Fay de Lavallaz, Jeanne

AU - Sabti, Zaid

AU - Sazgary, Lorraine

AU - Puelacher, Christian

AU - Mueller, Deborah

AU - Bianci, Chiara

AU - Miró, Òscar

AU - Fuenzalida, Carolina

AU - Calderón, Sofia

AU - Martín-Sánchez, F Javier

AU - Iglesias, Sergio Lopez

AU - Morawiec, Beata

AU - Kawecki, Damian

AU - Parenica, Jiri

AU - Keller, Dagmar I

AU - Geigy, Nicolas

AU - Osswald, Stefan

AU - Mueller, Christian

AU - Reichlin, Tobias

PY - 2018

Y1 - 2018

N2 - 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.

AB - 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.

KW - Aged

KW - Aged, 80 and over

KW - Cause of Death/trends

KW - Electrocardiography

KW - Europe/epidemiology

KW - Female

KW - Follow-Up Studies

KW - Heart Rate/physiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Infarction/diagnosis

KW - Prognosis

KW - Prospective Studies

KW - Risk Factors

U2 - 10.5603/CJ.a2018.0033

DO - 10.5603/CJ.a2018.0033

M3 - SCORING: Journal article

C2 - 29611166

VL - 25

SP - 601

EP - 610

JO - CARDIOL J

JF - CARDIOL J

SN - 1897-5593

IS - 5

ER -