Prediction of sudden death from QTc interval prolongation in patients with chronic ischemic heart disease
Abstract
Although prolongation of QTc interval has been shown to increase the risk of sudden death after recent myocardial infarction, no data exist on the relationship between sudden death and QTc duration in patients with chronic ischemic heart disease. Furthermore, it is not known whether patients with long QTc intervals (greater than or equal to 440 units) have more prevalent coronary risk factors. Thus 141 nonsurvivors (128 with coronary death and 13 with noncoronary death) representing the follow-up deaths of a cohort of 1157 medically treated patients with ischemic heart disease over a four-year period were compared to 141 consecutive long-term survivors of the same cohort. Thirty-one patients were excluded because of drug interactions, bundle-branch block or atrial fibrillation. QTc duration was calculated on the ECG immediately prior to angiography in 62 patients with sudden death, 36 with intermediate death, 13 with noncoronary death and 140 long-term survivors with chronic ischemic heart disease. In addition, in 64 nonsurvivors (58%) in whom more than one yearly follow-up ECG was available, QTc was calculated in the last ECG preceding death (mean of four months before death). These data were compared to those obtained in 140 ...Continue Reading
References
Outcome in medically treated coronary artery disease. Ischemic events: nonfatal infarction and death
A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results
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