T AMIN1, A MALAWEERA1, MD N KARIM2, M ROBERTS 1, L MCMAHON1
1Eastern Health Service, Melbourne, Victoria; 2Monash University, Clayton, Victoria
INTRODUCTION: Cardiovascular mortality is the leading cause of death in haemodialysis patients. In search of possible clue, we assessed association of electrocardiography (ECG) substrate with mortality and cardiovascular events (CVE) in maintenance haemodialysis patients.
METHOD: We analysed 104 maintenance haemodialysis patients’ data that include demographic, pre-existing comorbidities, duration on dialysis, urea reduction rate (URR), QRS and QTc duration. ECG was conducted on all patients between March 2013 and June 2014. All-cause-mortality and CVE were considered as outcome and were collected between December 2013 and December 2015. CVE was defined as new acute coronary syndrome and or sudden cardiac death. Factors of mortality and CVE were identified through univariate association and were confirmed by multivariate logistic regression thus adjusting for possible confounders.
RESULT: During the 2-year follow-up 24 deaths and 19 CVE were observed. Patients who died (119.1 ± 30.8) had a significantly higher QRS than patients who were alive (99.6± 25.0; P=0.002). Similarly, patients with CVE (121.7 ± 35.6) had significantly higher QRS than patients with no CVE (100.1 ± 23.9; P=0.002). QTc Duration did not differ significantly across death or CVE status (p>0.05). Multivariate logistic regression confirms association of QRS duration with all-cause mortality (OR 1.026, 95% CI 1.006,1.047; p=0.012) and CVE (OR 1.028, 95% CI 1.005,1.051; p=0.016) adjusted for age, gender, duration on dialysis, coronary artery disease status, diabetes status and URR.
CONCLUSION: Prolonged QRS is significantly associated with all cause mortality and cardiovascular events in patients with maintenance haemodialysis.