Wu Cheng-Ching, Lu Yung-Chuan, Yu Teng-Hung, Wang Chao-Ping, Hung Wei-Chin, Tang Wei-Hua, Tsai I-Ting, Chung Fu-Mei, Lee Yau-Jiunn, Hu Jin-Jia
Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
Intern Med J. 2018 Oct;48(10):1242-1251. doi: 10.1111/imj.13796.
Lower concentrations of serum albumin appear to be associated with an increased risk of all-cause and cardiovascular mortality, coronary heart disease, heart failure and stroke. However, little is known about the relationship between serum albumin level and prolonged QT interval.
To investigate whether lower serum albumin is associated with prolonged QT interval by recording 12-lead electrocardiography in patients with coronary artery disease and chronic kidney disease.
This study included 1383 consecutive patients with coronary artery disease and chronic kidney disease (841 with acute coronary syndrome and 542 with elective percutaneous coronary intervention patients) who were enrolled in a disease management programme. Twelve-lead electrocardiography was recorded in each subject. We assessed the relationship between albumin levels (both as a continuous variable and stratified by tertile) at admission and corrected QT (QTc) prolongation.
Patients with abnormal QTc interval had lower serum albumin levels than those with normal and borderline QTc intervals. Statistically significant negative associations were observed between serum albumin levels and QTc interval (β = -0.211, P < 0.0001). Using multivariate and trend analyses, a lower concentration of serum albumin was independently associated with QTc prolongation in both the patients with acute coronary syndrome and elective percutaneous coronary intervention patients.
Concentrations of serum albumin were significantly lower in the patients with an abnormal QTc interval and were associated with QTc prolongation. Further studies are needed to clarify whether lower serum albumin plays a role in the pathogenesis of QTc prolongation.
血清白蛋白浓度较低似乎与全因死亡率和心血管死亡率、冠心病、心力衰竭及中风风险增加相关。然而,关于血清白蛋白水平与QT间期延长之间的关系却知之甚少。
通过记录冠心病和慢性肾脏病患者的12导联心电图,研究较低的血清白蛋白是否与QT间期延长有关。
本研究纳入了1383例连续的冠心病和慢性肾脏病患者(841例急性冠脉综合征患者和542例择期经皮冠状动脉介入治疗患者),这些患者均参与了一项疾病管理项目。为每位受试者记录12导联心电图。我们评估了入院时白蛋白水平(作为连续变量并按三分位数分层)与校正QT(QTc)延长之间的关系。
QTc间期异常的患者血清白蛋白水平低于QTc间期正常和临界的患者。血清白蛋白水平与QTc间期之间存在显著的负相关(β = -0.211,P < 0.0001)。通过多变量和趋势分析,较低的血清白蛋白浓度在急性冠脉综合征患者和择期经皮冠状动脉介入治疗患者中均与QTc延长独立相关。
QTc间期异常的患者血清白蛋白浓度显著较低,且与QTc延长相关。需要进一步研究以阐明较低的血清白蛋白是否在QTc延长的发病机制中起作用。