Electrocardiographic QT interval and mortality: a meta-analysis.
Electrocardiographic QT interval and mortality: a meta-analysis.
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DOI：
10.1097/ede.0b013e318225768b
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发表时间：
2011-09
期刊：
影响因子：
--
通讯作者：
Guallar E
中科院分区：
文献类型：
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作者：
Zhang Y;Post WS;Blasco-Colmenares E;Dalal D;Tomaselli GF;Guallar E
严重异常的心电图QT间期延长与恶性室性心律失常和心脏性猝死有关。然而，QT间期长度在正常范围内的变化对普通人群死亡率的影响仍不清楚。我们进行了荟萃分析来研究QT间期与死亡率终点的关系。使用逆方差加权随机效应模型来总结研究中的相对风险。纳入了23项观察性研究。比较QT间期长度最高和最低类别的合并相对风险估计为：总死亡率1.35(95%可信区间=1.24-1.46)，心血管死亡率1.51(1.29-1.78)，冠心病死亡率1.71(1.36-2.15)，心源性猝死1.44(1.01-2.04)。QT间期延长50毫秒与总死亡率1.20(1.15-1.26)、心血管死亡率1.29(1.15-1.46)、冠心病死亡率1.49(1.25-1.76)、心源性猝死1.24(0.97-1.60)相关。我们发现QT间期延长与总死亡、心血管死亡、冠状动脉死亡和心脏性猝死风险增加之间存在一致的相关性。QT间期长度是一般人群死亡率的决定因素。
Extremely abnormal prolongation of the electrocardiographic QT interval is associated with malignant ventricular arrhythmias and sudden cardiac death. However, the implications of variations in QT-interval length within normal limits for mortality in the general population are still unclear. We performed a meta-analysis to investigate the relation of QT interval with mortality endpoints. Inverse-variance weighted random-effects models were used to summarize the relative risks across studies. Twenty-three observational studies were included. The pooled relative risk estimates comparing the highest with the lowest categories of QT-interval length were 1.35 (95% confidence interval = 1.24–1.46) for total mortality, 1.51 (1.29–1.78) for cardiovascular mortality, 1.71 (1.36–2.15) for coronary heart disease mortality, and 1.44 (1.01–2.04) for sudden cardiac death. A 50 msec increase in QT interval was associated with a relative risk of 1.20 (1.15–1.26) for total mortality, 1.29 (1.15–1.46) for cardiovascular mortality, 1.49 (1.25–1.76) for coronary heart disease mortality, and 1.24 (0.97–1.60) for sudden cardiac death. We found consistent associations between prolonged QT interval and increased risk of total, cardiovascular, coronary, and sudden cardiac death. QT-interval length is a determinant of mortality in the general population.