Prolonged QRS independently predicts long-term all-cause mortality in patients with narrow QRS complex undergoing coronary artery bypass grafting surgery (9-year follow-up results)

Turan Erdoğan; Mustafa Çetin; Ali Özyıldız; Savaş Özer; Abdülkadir Uslu; Sedat Karakişi; Tuncay Kırış

doi:10.5114/kitp.2020.99073

Abstract

3/2020 vol. 17

Original paper

Prolonged QRS independently predicts long-term all-cause mortality in patients with narrow QRS complex undergoing coronary artery bypass grafting surgery (9-year follow-up results)

Turan Erdoğan ¹

,

Mustafa Çetin ¹

,

Ali Gökhan Özyıldız ²

,

Savaş Özer ²

,

Abdülkadir Uslu ³

,

Sedat Ozan Karakişi ⁴

,

Tuncay Kırış ⁵

Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
Department of Cardiology, Recep Tayyip Erdoğan University, Training and Research Hospital, Rize, Turkey
Department of Cardiology, Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
Department of Cardiovascular Surgery, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
Department of Cardiology, Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey

Kardiochir Torakochir Pol 2020; 17 (3): 117-122

DOI: https://doi.org/10.5114/kitp.2020.99073

Online publish date: 2020/09/23

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AMA

Erdoğan T, Çetin M, Özyıldız AG, et al. Prolonged QRS independently predicts long-term all-cause mortality in patients with narrow QRS complex undergoing coronary artery bypass grafting surgery (9-year follow-up results). Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2020;17(3):117-122. doi:10.5114/kitp.2020.99073.

APA

Erdoğan, T., Çetin, M., Özyıldız, A. G., Özer, S., Uslu, A., & Karakişi, S. O. et al. (2020). Prolonged QRS independently predicts long-term all-cause mortality in patients with narrow QRS complex undergoing coronary artery bypass grafting surgery (9-year follow-up results). Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 17(3), 117-122. https://doi.org/10.5114/kitp.2020.99073

Chicago

Erdoğan, Turan, Mustafa Çetin, Ali G Özyıldız, Savaş Özer, Abdülkadir Uslu, Sedat O Karakişi, and Tuncay Kırış. 2020. "Prolonged QRS independently predicts long-term all-cause mortality in patients with narrow QRS complex undergoing coronary artery bypass grafting surgery (9-year follow-up results)". Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery 17 (3): 117-122. doi:10.5114/kitp.2020.99073.

Harvard

Erdoğan, T., Çetin, M., Özyıldız, A., Özer, S., Uslu, A., Karakişi, S., and Kırış, T. (2020). Prolonged QRS independently predicts long-term all-cause mortality in patients with narrow QRS complex undergoing coronary artery bypass grafting surgery (9-year follow-up results). Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 17(3), pp.117-122. https://doi.org/10.5114/kitp.2020.99073

MLA

Erdoğan, Turan et al. "Prolonged QRS independently predicts long-term all-cause mortality in patients with narrow QRS complex undergoing coronary artery bypass grafting surgery (9-year follow-up results)." Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, vol. 17, no. 3, 2020, pp. 117-122. doi:10.5114/kitp.2020.99073.

Vancouver

Erdoğan T, Çetin M, Özyıldız A, Özer S, Uslu A, Karakişi S et al. Prolonged QRS independently predicts long-term all-cause mortality in patients with narrow QRS complex undergoing coronary artery bypass grafting surgery (9-year follow-up results). Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2020;17(3):117-122. doi:10.5114/kitp.2020.99073.

Aim

We investigated the association of intermediate QRS prolongation with the long-term all-cause mortality in coronary artery bypass grafting (CABG) surgery patients with a narrow QRS complex in the preoperative electrocardiography (ECG).

Material and methods

A total of 221 consecutive patients with narrow QRS (< 120 ms) sinus rhythm who underwent CABG surgery were included in the study. The patients were followed up for 9.2 years postoperatively in terms of mortality outcomes.

Results

Follow-up data were obtained from 211 (173 men, 38 women) of 221 patients. Death occurred in 57 of them. We examined patients in the two groups according to survival outcomes. In multivariate COX regression analysis EuroSCORE (OR = 1.342, 95% CI: 1.167–1.544, p < 0.001), extent of coronary artery disease (OR = 1.768, 95% CI: 1.034–3.020, p = 0.037), QRS duration (OR = 1.029, 95% CI: 1.002–1.058, p = 0.035) and fasting glucose levels (OR = 0.992, 95% CI: 0.984–0.999, p = 0.029) were independent predictors of all-cause mortality. QRS duration > 89.5 ms determined all-cause mortality with a sensitivity of 73.7% and a specificity of 52% (OR = 2.07) due to ROC analysis. All-cause mortality was significantly higher in patients with preop QRS duration > 90 ms from the first year (χ² = 6.724, p = 0.010).

Conclusions

In CABG patients with a narrow QRS complex, preoperative intermediate prolonged QRS is an independent predictor of all-cause mortality in long-term follow-up.