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Abstract: FR-PO1044

Impact of Electrocardiographic Finding on Cardiac Mortality in Hemodialysis Patients: Ten-Year Outcomes of the Q-Cohort Study

Session Information

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.