Key result
PR interval prolongation is not associated with increased 1-year all-cause mortality.
Why the study?
Previous studies linking PR interval prolongation to mortality had limited confounder control, and its clinical impact in acutely ill patients was unknown.
Does PR interval prolongation predict 1-year all-cause mortality in adult patients presenting to the emergency department?
Cohort (n=106,124)
Yes
Does PR interval prolongation predict 1-year all-cause mortality in adult patients presenting to the emergency department?
PR interval prolongation on a single ED ECG is largely driven by age and comorbidities, and does not independently predict 1-year mortality in acutely ill patients.
Answers are grounded in this paper and cite their sources.
PR prolongation shows no independent link to 1-year mortality in ED patients; leaves open its value as a marker after full confounder adjustment in broader settings.
OBJECTIVES: Emerging evidence supports that PR interval prolongation is associated with increased mortality. However, most previous studies have limited confounder control, and clinical impact in a population of acute ill patients is unknown. The aim of this study was to investigate whether 1-year all-cause mortality was increased in patients presenting with PR interval prolongation in the emergency department (ED). DESIGN AND SETTING: We conducted a register-based cohort study in two Swedish and two Danish EDs. We included all adult patients with an ECG performed at arrival to the Danish EDs during March 2013 to May 2014 and Swedish EDs during January 2010 to January 2011. Using propensity score matching, we analysed HR for 1-year all-cause mortality comparing patients with PR interval prolongation (>200 ms) and normal PR interval (120-200 ms). PARTICIPANTS AND RESULTS: We included 106 124 patients. PR interval prolongation occurred in 8.9% (95% CI 8.7% to 9.0%); these patients were older and had more comorbidity than those with a normal PR interval. The absolute 1-year risk of death was 13% (95% CI 12.3% to 13.7%) for patients with PR interval prolongation and 7.9% (95% CI 7.7% to 8.0%) for those without. After confounder adjustments by propensity score matching, PR interval prolongation showed no association with 1-year mortality with a HR of 1.00 (95% CI 0.93% to 1.08%). CONCLUSION: PR interval prolongation does not constitute an independent risk factor for 1-year mortality in ED patients.
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Vad et al. (2021) conducted a cohort in Acutely ill patients presenting to the emergency department (n=106,124). PR interval prolongation (>200 ms) vs. Normal PR interval (120-200 ms) was evaluated on 1-year all-cause mortality (HR 1.00, 95% CI 0.93 to 1.08). PR interval prolongation was not associated with an increased risk of 1-year all-cause mortality after adjusting for confounders (HR 1.00, 95% CI 0.93 to 1.08).
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