title: QT interval Independently Predicts Mortality and Heart Failure in Patients with ST-Elevation Myocardial Infarction.
abstract: OBJECTIVE
  Heart-rate corrected QT (QTc) interval predicts cardiovascular mortality or all-cause mortality in the general population. Little is known about the best cut-off value of QTc interval for predicting clinical events in patients with ST-elevation myocardial infarction (STEMI).
  
  
  METHODS
  We enrolled 264 patients with STEMI who received measurement of QTc intervals at ER (QTc-ER), on day 2 (QTc-D2), and on day 3 (QTc-D3) of hospitalization. Clinical events, including all-cause death and readmission for heart failure, were followed for 2 years.
  
  
  RESULTS
  Prolonged QTc-ER, but not QTc-D2 or QTc-D3, well predicted clinical events with the best cut-off value of 445 ms. Patient with QTc-ER > 445 ms had lower left ventricular ejection fraction at baseline and at 6 months. Kaplan-Meier survival curves showed that the combination of QTc-ER > 445 ms and N-terminal pro-brain natriuretic peptide (NT-pro BNP) > 936 pg/mL was a strong predictor of clinical events (p<0.001). In multivariable Cox regression analysis, the independent predictors of death and heart failure were QTc-ER (p<0.001), log NT-proBNP (p<0.001), diabetes mellitus (p<0.001), history of stroke (p=0.001), and left ventricular end diastolic volume index (p<0.001).
  
  
  CONCLUSIONS
  QTc-ER > 445 ms independently predicts clinical events in STEMI, providing incremental prognostic value to established clinical predictors and NT-proBNP.
authors.affiliation: 1. Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; ; 2. School of Medicine, Tzu Chi University, Hualien, Taiwan;
authors.forename: Jeng-Feng
authors.initials: JF
authors.lastname: Lin
authors.affiliation: 1. Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; ; 2. School of Medicine, Tzu Chi University, Hualien, Taiwan;
authors.forename: Shun-Yi
authors.initials: SY
authors.lastname: Hsu
authors.affiliation: 1. Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; ; 3. Department of Life Science, Chinese Culture University, Taipei, Taiwan.
authors.forename: Semon
authors.initials: S
authors.lastname: Wu
authors.affiliation: 1. Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan;
authors.forename: Ming-Sheng
authors.initials: MS
authors.lastname: Teng
authors.affiliation: 1. Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan;
authors.forename: Hsin-Hua
authors.initials: HH
authors.lastname: Chou
authors.affiliation: 1. Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan;
authors.forename: Shih-Tsung
authors.initials: ST
authors.lastname: Cheng
authors.affiliation: 1. Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan;
authors.forename: Tien-Yu
authors.initials: TY
authors.lastname: Wu
authors.affiliation: 1. Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; ; 2. School of Medicine, Tzu Chi University, Hualien, Taiwan;
authors.forename: Yu-Lin
authors.initials: YL
authors.lastname: Ko
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000503:physiopathology*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D013624:Taiwan / Q000453:epidemiology; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: QT interval; acute myocardial infarction; brain natriuretic peptide; left ventricular remodeling.