Key result
Prolonged QRS duration on admission in patients with Takotsubo cardiomyopathy was independently associated with a 5-fold higher risk of in-hospital mortality (OR 5.06).
Why the study?
Does prolonged QRS duration on admission predict poor in-hospital clinical outcomes in patients with Takotsubo cardiomyopathy?
Cohort (n=299)
Yes
Does prolonged QRS duration on admission predict poor in-hospital clinical outcomes in patients with Takotsubo cardiomyopathy?
Prolonged QRS duration on admission in patients with Takotsubo cardiomyopathy is an independent predictor of in-hospital mortality and cardiac death, suggesting a need for aggressive intervention.
Prolonged QRS may flag higher-risk Takotsubo patients; leaves open whether it should guide care pending prospective validation.
BACKGROUND: Prolonged QRS duration (pQRSd) on electrocardiogram (ECG) is a strong predictor of poor outcome in heart failure, myocardial infarction, and myocarditis, but it is unclear whether pQRSd also predicts poor outcomes of takotsubo cardiomyopathy (TC). METHODS AND RESULTS: Between 1 January 2010 and 31 December 2012, we retrospectively enrolled 299 patients with TC (mean age, 73.5±11.7 years; 21.4% male) from the Tokyo CCU Network database, which consists of 71 cardiovascular centers in the metropolitan area. In-hospital clinical outcomes were compared between patients with pQRSd on admission ECG (QRS ≥120 ms; n=34) and those with normal QRS duration (<120 ms; n=265). The in-hospital mortality rate for pQRSd was significantly higher than that for normal QRS duration (23.5% vs. 3.8%, P<0.001). Similarly, prevalence of ventilator use (38.2% vs. 11.4%, P<0.001), ventricular tachycardia or fibrillation (14.7% vs. 1.5%, P<0.001), and circulatory failure requiring catecholamine or cardiopulmonary supportive devices (41.2% vs. 14.0%, P<0.001) was significantly higher in the pQRSd group. On multivariate logistic regression analysis, pQRSd was an independent predictor for both in-hospital mortality (OR, 5.06; 95% CI: 1.79-14.30, P=0.002) and cardiac death (OR, 7.34; 95% CI: 1.33-40.51, P=0.02). CONCLUSIONS: TC with pQRSd is associated with poor in-hospital clinical outcome. Aggressive intervention may be required to prevent severe complications in these patients.
No takes yet. Share an insight, caveat, or question.
Yamaguchi et al. (2016) conducted a cohort in Takotsubo cardiomyopathy (n=299). Prolonged QRS duration (≥120 ms) vs. Normal QRS duration (<120 ms) was evaluated on In-hospital mortality (OR 5.06, 95% CI 1.79-14.30, p=0.002). Prolonged QRS duration on admission in patients with Takotsubo cardiomyopathy was independently associated with a 5-fold higher risk of in-hospital mortality (OR 5.06).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: