biostudies-literatureUnknown112(12)Miro OInstituto de Salud Carlos IIIUniversitat de Barcelona<h4>Objective</h4>To investigate the association of corrected QT (QTc) interval duration and short-term outcomes in patients with acute heart failure (AHF).<h4>Methods</h4>We analyzed AHF patients enrolled in 11 Spanish emergency departments (ED) for whom an ECG with QTc measurement was available. Patients with pace-maker rhythm were excluded. Primary outcome was 30-day all-cause mortality and secondary outcomes were need of hospitalization, in-hospital mortality and prolonged hospitalization (> 7 days). Association between QTc and outcomes was explored by restricted cubic spline (RCS) curves. Results were expressed as odds ratios (OR) and 95%CI adjusted by patients baseline and decompensation characteristics, using a QTc = 450 ms as reference.<h4>Results</h4>Of 1800 patients meeting entry criteria (median age 84 years (IQR = 77-89), 56% female), their median QTc was 453 ms (IQR = 422-483). The 30-day mortality was 9.7%, while need of hospitalization, in-hospital mortality and prolonged hospitalization were 77.8%, 9.0% and 50.0%, respectively. RCS curves found longer QTc was associated with 30-day mortality if > 561 ms, OR = 1.86 (1.00-3.45), and increased up to OR = 10.5 (2.25-49.1), for QTc = 674 ms. A similar pattern was observed for in-hospital mortality; OR = 2.64 (1.04-6.69), for QTc = 588 ms, and increasing up to OR = 8.02 (1.30-49.3), for QTc = 674 ms. Conversely, the need of hospitalization had a U-shaped relationship: being increased in patients with shorter QTc [OR = 1.45 (1.00-2.09) for QTc = 381 ms, OR = 5.88 (1.25-27.6) for the shortest QTc of 200 ms], and also increasing for prolonged QTc [OR = 1.06 (1.00-1.13), for QTc = 459 ms, and reaching OR = 2.15 (1.00-4.62) for QTc = 588 ms]. QTc was not associated with prolonged hospitalization.<h4>Conclusion</h4>In ED AHF patients, initial QTc provides independent short-term prognostic information, with increasing QTc associated with increasing mortality, while both, shortened and prolonged QTc are associated with need of hospitalization.Clinical research in cardiology : official journal of the German Cardiac Society1754-1765https://www.ebi.ac.uk/biostudies/studies/S-EPMC10698082biostudies-literatureQT interval and short-term outcome in acute heart failure.PMC10698082Sanchez Gonzalez MJavaloyes PAmores Arriaga BMinguez Maso SLlopis Garcia GLlauger Garcia LAlonso HGarcia Garcia MCalderon Jave LEComas PRodriguez Miranda BHerrero-Puente PLlauger LAguilo OAguera Urbano CMueller CAguirre ATraveria Becquer LRafique ZAguilo SGarcia Soto ABKeene KRFuentes MPerez-Llantada EAdroher Munoz MGil AValero AAlarcon Jimenez BSGil CPeacock FLopez-Ayala PLorca Serralta MTJuan MAHerrera SPavon JPedragosa MARichard FPinera PRoset ACabello IFranco JMDelgado Padial EBerenguer MEscoda RComa Casanova PMartin Mojarro ESanchez CRuiz FGil VLopez-Diez MPRodriguez-Adrada ECorominas LaSalle GSanchez Ramon SMont LGaya RTrullas JCVazquez Alvarez JMiro ONunez JMecina ABMolina FLopez-Grima MLBibiano CMir MRuiz MGarrido JMJacob JLlorens PVicente Martin MAlvarez Perez JMRizzi MAGarcia THerrero Puente PEspinosa BSierra Bergua BCarbajosa Rodriguez VDonea RMillan JCarballo JLMontero Perez-Barquero MBurillo GTost JRodriguez BAndueza JACadenas MSSoy Ferrer EAlonso MIRomero RHaro APrieto Garcia BLucas-Imbernon FJMartin-Sanchez FJEspinach Alvaros JICA-SEMES research investigatorsHernandez NSanchez Nicolas JATorres Garate RJimenez ICalvache RNoval AAlquezar-Arbe AfalseQT interval and short-term outcome in acute heart failure.<h4>Objective</h4>To investigate the association of corrected QT (QTc) interval duration and short-term outcomes in patients with acute heart failure (AHF).<h4>Methods</h4>We analyzed AHF patients enrolled in 11 Spanish emergency departments (ED) for whom an ECG with QTc measurement was available. Patients with pace-maker rhythm were excluded. Primary outcome was 30-day all-cause mortality and secondary outcomes were need of hospitalization, in-hospital mortality and prolonged hospitalization (> 7 days). Association between QTc and outcomes was explored by restricted cubic spline (RCS) curves. Results were expressed as odds ratios (OR) and 95%CI adjusted by patients baseline and decompensation characteristics, using a QTc = 450 ms as reference.<h4>Results</h4>Of 1800 patients meeting entry criteria (median age 84 years (IQR = 77-89), 56% female), their median QTc was 453 ms (IQR = 422-483). The 30-day mortality was 9.7%, while need of hospitalization, in-hospital mortality and prolonged hospitalization were 77.8%, 9.0% and 50.0%, respectively. RCS curves found longer QTc was associated with 30-day mortality if > 561 ms, OR = 1.86 (1.00-3.45), and increased up to OR = 10.5 (2.25-49.1), for QTc = 674 ms. A similar pattern was observed for in-hospital mortality; OR = 2.64 (1.04-6.69), for QTc = 588 ms, and increasing up to OR = 8.02 (1.30-49.3), for QTc = 674 ms. Conversely, the need of hospitalization had a U-shaped relationship: being increased in patients with shorter QTc [OR = 1.45 (1.00-2.09) for QTc = 381 ms, OR = 5.88 (1.25-27.6) for the shortest QTc of 200 ms], and also increasing for prolonged QTc [OR = 1.06 (1.00-1.13), for QTc = 459 ms, and reaching OR = 2.15 (1.00-4.62) for QTc = 588 ms]. QTc was not associated with prolonged hospitalization.<h4>Conclusion</h4>In ED AHF patients, initial QTc provides independent short-term prognostic information, with increasing QTc associated with increasing mortality, while both, shortened and prolonged QTc are associated with need of hospitalization.2023-01-01T00:00:00Z2023 Dec2025-04-26T11:47:12.585Z2025-04-06T13:48:23.963ZS-EPMC106980823700452710.1007/s00392-023-02173-9