PHILADELPHIA—Abnormalities revealed by electrocardiography (ECG) may predict which patients undergoing evaluation for a renal transplant are at higher risk of death, a study found. These abnormalities include prolonged PR or QTc intervals.
The findings suggest that ECG findings could be “simple yet potentially powerful prognostic tool for assessment” of renal transplant candidates, said investigator Peter Flueckiger, a fourth-year medical student at Emory University in Atlanta.
Flueckiger, who presented findings at the 2011 American Transplant Congress, and his colleagues examined the relationship between ECG interval measurements (PR interval greater than 200 ms, QRS interval greater than 110 ms, and QTc interval greater than 450 ms) and mortality in 930 adult patients with end-stage renal disease evaluated for renal transplantation from September 2006-October 2008. Researchers abstracted ECG data from patient charts and linked with mortality data from the Social Security Death Index.
Of the 930 patients, 108 (11.6%) died after a median follow-up of 7.3 months. Subjects had a mean age of 50 years; 57% were male, and 60% were black. The mean PR interval was 167.2 ms, QRS interval, 92.3 ms, and QTc interval, 450.3 ms. Results showed that 9.7% of subjects had PR intervals greater than 200 ms, 4.5% had QRS intervals greater than 110 ms, and 49% had QTc greater than 450 ms.
Compared with patients with no ECG interval abnormalities, those with PR intervals greater than 200 ms (compared with less than 200 ms) and QTc intervals greater than 450 ms (compared with less than 450 ms) had a significant twofold increased likelihood of dying, after adjusting for age, race, and gender. In contrast, patients with QRS greater than 110 ms were no more likely to die those with QRS less than 110 ms. Patients with two or more ECG interval abnormalities had a significant threefold increased risk of dying.