Prolonged QTc interval predicts long-term mortality in cirrhosis: a propensity score matching analysis

• Published in: Scandinavian journal of gastroenterology Vol. 56; no. 5; p. 570
• Main Authors: Li, Shuhong, Hao, Xuwen, Liu, Simiao, Gong, Yanxia, Niu, Wei, Tang, Yanping
• Format: Journal Article
• Language: English
• Published: England 04.05.2021
• Subjects: Electrocardiography; Heart Rate; Humans; Infant, Newborn; Liver Cirrhosis - complications; Long QT Syndrome; Propensity Score; Risk Factors; QTc; cirrhotic cardiomyopathy; propensity score matching; cirrhosis
• ISSN: 1502-7708
• DOI: 10.1080/00365521.2021.1901307

Prolonged corrected QT (QTc) interval is a hallmark of cirrhotic cardiomyopathy (CCM) and has been ascertained to predict mortality in cirrhosis. However, some critical issues remain to be addressed including unanimous cut-off, calculation approach and applicable population. A total of 274 patients with cirrhosis were included. The prolonged QTc interval over 440 ms according to adjusted Fridericia's formula was used to stratify enrolled subjects. Independent predictors of 3-year mortality were identified with Cox regression model. The Kaplan-Meier method was implemented to obtain survival curves. To reduce impact of selection bias and possible confounders, a propensity score matching (PSM) analysis was used. QTc > 440 ms was an independent risk factor in the entire cohort and PSM subset (HR 2.532, 95% CI 1.431-4.480, =.001; HR 2.802, 95% CI 1.171-6.701, =.021, respectively). Subgroup analysis showed that QTc > 440 ms was an independent predictor in cirrhotics with age ≤60 years (HR = 1.02, =.035) and in the presence of ascites (HR = 1.01, =.008). The prolonged QTc interval might help to identify patients with high-risk of all-cause mortality.