eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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3/2020
vol. 17
 
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abstract:
Original paper

Prolonged QRS independently predicts long-term all-cause mortality in patients with narrow QRS complex undergoing coronary artery bypass grafting surgery (9-year follow-up results)

Turan Erdoğan
1
,
Mustafa Çetin
1
,
Ali Gökhan Özyıldız
2
,
Savaş Özer
2
,
Abdülkadir Uslu
3
,
Sedat Ozan Karakişi
4
,
Tuncay Kırış
5

  1. Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
  2. Department of Cardiology, Recep Tayyip Erdoğan University, Training and Research Hospital, Rize, Turkey
  3. Department of Cardiology, Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
  4. Department of Cardiovascular Surgery, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
  5. Department of Cardiology, Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
Kardiochir Torakochir Pol 2020; 17 (3): 117-122
DOI: https://doi.org/10.5114/kitp.2020.99073
Online publish date: 2020/09/23
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Aim
We investigated the association of intermediate QRS prolongation with the long-term all-cause mortality in coronary artery bypass grafting (CABG) surgery patients with a narrow QRS complex in the preoperative electrocardiography (ECG).

Material and methods
A total of 221 consecutive patients with narrow QRS (< 120 ms) sinus rhythm who underwent CABG surgery were included in the study. The patients were followed up for 9.2 years postoperatively in terms of mortality outcomes.

Results
Follow-up data were obtained from 211 (173 men, 38 women) of 221 patients. Death occurred in 57 of them. We examined patients in the two groups according to survival outcomes. In multivariate COX regression analysis EuroSCORE (OR = 1.342, 95% CI: 1.167–1.544, p < 0.001), extent of coronary artery disease (OR = 1.768, 95% CI: 1.034–3.020, p = 0.037), QRS duration (OR = 1.029, 95% CI: 1.002–1.058, p = 0.035) and fasting glucose levels (OR = 0.992, 95% CI: 0.984–0.999, p = 0.029) were independent predictors of all-cause mortality. QRS duration > 89.5 ms determined all-cause mortality with a sensitivity of 73.7% and a specificity of 52% (OR = 2.07) due to ROC analysis. All-cause mortality was significantly higher in patients with preop QRS duration > 90 ms from the first year (χ2 = 6.724, p = 0.010).

Conclusions
In CABG patients with a narrow QRS complex, preoperative intermediate prolonged QRS is an independent predictor of all-cause mortality in long-term follow-up.

keywords:

coronary artery bypass grafting, QRS duration, all-cause mortality, long-term follow-up
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