Erdoğan Turan, Çetin Mustafa, Özyıldız Ali Gökhan, Özer Savaş, Uslu Abdülkadir, Karakişi Sedat Ozan, Kırış Tuncay
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.
Kardiochir Torakochirurgia Pol. 2020 Sep;17(3):117-122. doi: 10.5114/kitp.2020.99073. Epub 2020 Sep 23.
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).
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.
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, < 0.001), extent of coronary artery disease (OR = 1.768, 95% CI: 1.034-3.020, = 0.037), QRS duration (OR = 1.029, 95% CI: 1.002-1.058, = 0.035) and fasting glucose levels (OR = 0.992, 95% CI: 0.984-0.999, = 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 (c = 6.724, = 0.010).
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.
我们研究了在术前心电图（ECG）显示QRS波群狭窄的冠状动脉旁路移植术（CABG）患者中，QRS波群中度延长与长期全因死亡率之间的关联。
本研究纳入了221例连续接受CABG手术且QRS波群狭窄（<120毫秒）的窦性心律患者。对患者术后9.2年的死亡率进行随访。
221例患者中有211例（173例男性，38例女性）获得了随访数据。其中57例死亡。我们根据生存结果对两组患者进行了检查。在多变量COX回归分析中，欧洲心脏手术风险评估系统（EuroSCORE）（比值比[OR]=1.342，95%置信区间[CI]：1.167-1.544，P<0.001）、冠状动脉疾病程度（OR=1.768，95%CI：1.034-3.020，P=0.037）、QRS波群时限（OR=1.029，95%CI：1.002-1.058，P=0.035）和空腹血糖水平（OR=0.992，95%CI：0.984-0.999，P=0.029）是全因死亡率的独立预测因素。通过ROC分析，QRS波群时限>89.5毫秒可确定全因死亡率，敏感性为73.7%，特异性为52%（OR=2.07）。术前QRS波群时限>90毫秒的患者从第一年起全因死亡率显著更高（卡方检验值c=6.724，P=0.010）。
在QRS波群狭窄的CABG患者中，术前QRS波群中度延长是长期随访中全因死亡率的独立预测因素。
