A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome

Yıl: 2022 Cilt: 50 Sayı: 5 Sayfa Aralığı: 340 - 347 Metin Dili: İngilizce DOI: 10.5543/tkda.2022.21198 İndeks Tarihi: 26-07-2022

A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome

Öz:
Objective: This study aimed to evaluate whether the addition of heart rate-corrected QT interval prolongation to the Global Registry of Acute Coronary Events risk score improves the predictive value for early mortality in patients with non-ST segment elevation acute coronary syndrome. Methods: We retrospectively screened our database for consecutive non-ST-segment elevation acute coronary syndrome patients between January 2017 and July 2019. The demographic and clinical parameters were acquired via chart review. All electrocardiograms were reviewed by 2 physicians. QT interval was measured using the tangent method. Early mortality was defined as all-cause death observed during the hospital stay or within 30 days after discharge. Results: The final study population consisted of 283 patients, there were 17 early deaths. Ten of 59 patients with prolonged corrected QT intervals died (16.9%, P < .001). Both the Global Registry of Acute Coronary Events risk score (odds ratio: 1.032; 95% CI: 1.012-1.053; P = .002) and corrected QT interval (odds ratio: 1.026; 95% CI: 1.007-1.045; P = 0.007) independently predicted early mortality. The area under value was 0.769 (95% CI: 0.674-0.863, P < .001) for the corrected QT interval and 0.780 (95% CI:0.681-0.878; P < .001) for the Global Registry of Acute Coronary Events risk score alone. However, when the corrected QT interval and the Global Registry of Acute Coronary Events risk score were combined, it was found to be 0.808 (95% CI: 0.713-0.904, P < .001). Conclusion: This study is the first to report that prolonged corrected QT and the Global Registry of Acute Coronary Events risk score independently predict early mortality and a combination of these 2 factors may improve the predictive value for early mortality in patients with ST-segment elevation acute coronary syndrome.
Anahtar Kelime:

Kalp Hızı Düzeltilmiş QT Aralığı ve GRACE Risk Skorunun Bir Kombinasyonu ST-Segment Yüksekliği Olmayan Akut Koroner Sendromlu Hastalarda Erken Mortaliteyi Daha İyi Öngörür

Öz:
Amaç: Bu çalışma, kalp hızı düzeltilmiş QT aralığı (QTc) uzamasının GRACE risk skoruna eklenmesinin, ST-segment elevasyonu olmayan akut koroner sendromlu (NSTE-AKS) hastalarda erken mortalite için prediktif değeri iyileştirip iyileştirmediğini değerlendirmeyi amaçlamıştır. Yöntemler: Ocak 2017 ile Temmuz 2019 arasında ardışık NSTE-AKS hastaları için veri tabanımızı geriye dönük olarak taradık. Demografik ve klinik parametreler çizelge incelemesi yoluyla elde edildi. Tüm elektrokardiyogramlar 2 doktor tarafından incelendi. QT aralığı tanjant yöntemi kullanılarak ölçüldü. Erken ölüm, hastanede kalış sırasında veya taburcu olduktan sonraki 30 gün içinde gözlenen tüm nedenlere bağlı ölüm olarak tanımlandı. Bulgular: Çalışma popülasyonu 283 hastadan oluşuyordu, 17 erken ölüm vardı. QTc aralığı uzamış olan 59 hastanın onu öldü (%16.9, P < .001). Hem GRACE risk skoru (olasılık oranı: 1.032; %95 GA: 1.012 1.053; P = .002) hem de QTc aralığı (olasılık oranı: 1.026; %95 GA: 1.007-1.045; P = 0.007) bağımsız olarak erken mortaliteyi öngördü. Değerin altında kalan alan sadece QTc aralığı için 0.769 (%95 CI: 0.674-0.863, P < .001) ve sadece GRACE riski skoru için 0.780 (%95 CI:0.681-0.878; P < .001) idi. Ancak QTc aralığı ve GRACE risk skoru birleştirildiğinde 0.808 (%95 CI: 0.713-0.904, P < .001) bulundu. Sonuç: Bu çalışma, QTc aralığı uzama ve GRACE risk skorunun bağımsız olarak erken mortaliteyi öngördüğünü ve bu 2 faktörün bir kombinasyonunun NSTE-AKS’lu hastalarda erken mortalite için prediktif değeri iyileştirebileceğini bildiren ilk çalışmadır.
Anahtar Kelime:

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APA demirtas inci s, Tekindal M, ALTINSOY M, Özbeyaz N, Sunman H, Taş A, Yılmaz S, TEKELİ ŞENGÜL S, ALTIN C, Güllü H (2022). A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome. , 340 - 347. 10.5543/tkda.2022.21198
Chicago demirtas inci saadet,Tekindal Mustafa Agah,ALTINSOY Meltem,Özbeyaz Nail Burak,Sunman Hamza,Taş Alperen,Yılmaz Sabiye,TEKELİ ŞENGÜL SEBAHAT,ALTIN Cihan,Güllü Hakan A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome. (2022): 340 - 347. 10.5543/tkda.2022.21198
MLA demirtas inci saadet,Tekindal Mustafa Agah,ALTINSOY Meltem,Özbeyaz Nail Burak,Sunman Hamza,Taş Alperen,Yılmaz Sabiye,TEKELİ ŞENGÜL SEBAHAT,ALTIN Cihan,Güllü Hakan A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome. , 2022, ss.340 - 347. 10.5543/tkda.2022.21198
AMA demirtas inci s,Tekindal M,ALTINSOY M,Özbeyaz N,Sunman H,Taş A,Yılmaz S,TEKELİ ŞENGÜL S,ALTIN C,Güllü H A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome. . 2022; 340 - 347. 10.5543/tkda.2022.21198
Vancouver demirtas inci s,Tekindal M,ALTINSOY M,Özbeyaz N,Sunman H,Taş A,Yılmaz S,TEKELİ ŞENGÜL S,ALTIN C,Güllü H A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome. . 2022; 340 - 347. 10.5543/tkda.2022.21198
IEEE demirtas inci s,Tekindal M,ALTINSOY M,Özbeyaz N,Sunman H,Taş A,Yılmaz S,TEKELİ ŞENGÜL S,ALTIN C,Güllü H "A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome." , ss.340 - 347, 2022. 10.5543/tkda.2022.21198
ISNAD demirtas inci, saadet vd. "A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome". (2022), 340-347. https://doi.org/10.5543/tkda.2022.21198
APA demirtas inci s, Tekindal M, ALTINSOY M, Özbeyaz N, Sunman H, Taş A, Yılmaz S, TEKELİ ŞENGÜL S, ALTIN C, Güllü H (2022). A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome. Türk Kardiyoloji Derneği Arşivi, 50(5), 340 - 347. 10.5543/tkda.2022.21198
Chicago demirtas inci saadet,Tekindal Mustafa Agah,ALTINSOY Meltem,Özbeyaz Nail Burak,Sunman Hamza,Taş Alperen,Yılmaz Sabiye,TEKELİ ŞENGÜL SEBAHAT,ALTIN Cihan,Güllü Hakan A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome. Türk Kardiyoloji Derneği Arşivi 50, no.5 (2022): 340 - 347. 10.5543/tkda.2022.21198
MLA demirtas inci saadet,Tekindal Mustafa Agah,ALTINSOY Meltem,Özbeyaz Nail Burak,Sunman Hamza,Taş Alperen,Yılmaz Sabiye,TEKELİ ŞENGÜL SEBAHAT,ALTIN Cihan,Güllü Hakan A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome. Türk Kardiyoloji Derneği Arşivi, vol.50, no.5, 2022, ss.340 - 347. 10.5543/tkda.2022.21198
AMA demirtas inci s,Tekindal M,ALTINSOY M,Özbeyaz N,Sunman H,Taş A,Yılmaz S,TEKELİ ŞENGÜL S,ALTIN C,Güllü H A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome. Türk Kardiyoloji Derneği Arşivi. 2022; 50(5): 340 - 347. 10.5543/tkda.2022.21198
Vancouver demirtas inci s,Tekindal M,ALTINSOY M,Özbeyaz N,Sunman H,Taş A,Yılmaz S,TEKELİ ŞENGÜL S,ALTIN C,Güllü H A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome. Türk Kardiyoloji Derneği Arşivi. 2022; 50(5): 340 - 347. 10.5543/tkda.2022.21198
IEEE demirtas inci s,Tekindal M,ALTINSOY M,Özbeyaz N,Sunman H,Taş A,Yılmaz S,TEKELİ ŞENGÜL S,ALTIN C,Güllü H "A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome." Türk Kardiyoloji Derneği Arşivi, 50, ss.340 - 347, 2022. 10.5543/tkda.2022.21198
ISNAD demirtas inci, saadet vd. "A Combination of Heart Rate-Corrected QT Interval and GRACE Risk Score Better Predict Early Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndrome". Türk Kardiyoloji Derneği Arşivi 50/5 (2022), 340-347. https://doi.org/10.5543/tkda.2022.21198