Abstract: FR-PO1044
Impact of Electrocardiographic Finding on Cardiac Mortality in Hemodialysis Patients: Ten-Year Outcomes of the Q-Cohort Study
Session Information
- Hypertension and CVD: Clinical Outcomes, Trials
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1402 Hypertension and CVD: Clinical, Outcomes, and Trials
Authors
- Hiyamuta, Hiroto, Kyushu University, Fukuoka, Not Applicable, Japan
- Tanaka, Shigeru, Kyushu University, Fukuoka, Not Applicable, Japan
- Taniguchi, Masatomo, Fukuoka Renal Clinic, Fukuoka, Japan
- Nakano, Toshiaki, Kyushu University, Fukuoka, Not Applicable, Japan
- Tsuruya, Kazuhiko, Nara Medical University, Kashihara, Japan
- Kitazono, Takanari, Department of Medicine and Clinical Science, Fukuoka, Japan
Background
Electrocardiography is a noninvasive and inexpensive test and regularly performed in dialysis clinic. However, its clinical predictive value in hemodialysis patients is unclear. We investigated electrocardiographic finding associated cardiac-related mortality in Japanese hemodialysis patients.
Methods
A total of 1087 Japanese HD patients aged ≥18 years who underwent electrocardiography within 1 year from baseline were followed for 10 years. Multivariate-adjusted odds ratios (OR) with 95% confidence intervals (95% CI) for electrocardiographic finding of cardiac death were calculated using logistic regression analysis. To assess the additional predictive value of electrocardiographic finding in risk assessment, we compared the c-statistics between clinical model included electrocardiographic finding and basic model.
Results
During the follow-up period, 492 patients died totally, and 119 patients died of cardiac disease. After adjusting for confounding risk factors, heart rate (odds ratio [OR] for all cause moratality.1.46, 95% CI 1.28-1.67 for every 10/min increase), QT prolongation (OR 2.23, 95% CI 1.46-3.42), and left ventricular hypertrophy by Sokolow-Lyon voltage criteria (OR 1.81, 95% CI 1.15-2.86) was an independent predictor of cardiac-related mortality. The c-statistics of the traditional risk factors with the elcectrocardiographic findings in cardiac mortality were significantly increased compared to those of the traditional risk factors without the elcectrocardiographic findings (0.713 vs.0.753, p = 0.02).
Conclusion
We demonstrated electrocardiographic finding associated with all-cause and cardiac-related mortality in hemodialysis patients. Moreover, addition of the electrocardiographic finding to models with standard risk factors significantly improves the predictive ability of cardiac-related mortality.