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30 May 2014 : Original article  

Associations of ECG interval prolongations with mortality among ESRD patients evaluated for renal transplantation

Peter FlueckigerABDEF, Stephen PastanADE, Abinav GoyalAC, William W. McClellanACDEF, Rachel E. PatzerACDEF

DOI: 10.12659/AOT.889927

Ann Transplant 2014; 19:257-268

Abstract

BACKGROUND: It is unknown whether prolongation of electrocardiogram (ECG) intervals is associated with mortality in end-stage renal disease (ESRD) patients evaluated for renal transplantation.

MATERIAL AND METHODS: We examined the relationship between 12-lead ECG interval measurements (PR >200 ms, QRS >110 ms, or QTC >450 ms) and the presence of none, 1, and 2 or more ECG interval prolongations with all-cause mortality in 930 adult ESRD patients evaluated for renal transplantation from August 2006 to October 2008 and followed through November 2010.

RESULTS: A total of 108 (11.6%) patients died after a median follow-up of 3.1 years. A stepwise increase in all-cause mortality occurred among adult ESRD patients with prolongation of 1, and 2 or more ECG intervals. In adjusted analyses, the rate of death in patients with at least 1 ECG interval prolongation was 69% higher than that of patients with no ECG prolongations (HR=1.69; 95% CI: 1.05–2.73). Patients with 2 or more ECG interval prolongations had a 2.5-fold increased likelihood of dying vs. patients with no ECG interval prolongations (HR 2.53, 95% CI 1.38–4.82).

CONCLUSIONS: ECG interval prolongations are associated with higher mortality in patients evaluated for renal transplantation. The ECG is a potentially important evaluative tool for risk assessment in this population.

Keywords: electrocardiogram, end-stage renal disease, Epidemiology, renal transplantation, Mortality

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358