Abstract 9960: Electrocardiographic Intervals and Adverse Outcomes in People with Chronic Kidney Disease: Results from the Chronic Renal Insufficiency Cohort Study
Background: Abnormalities in electrocardiographic (ECG) intervals have been associated with death and heart failure. We sought to evaluate whether abnormal ECG intervals are associated with adverse events among people with chronic kidney disease (CKD).
Methods: We evaluated standard baseline ECGs among 3669 participants from the Chronic Renal Insufficiency Cohort Study (CRIC). The association between each of the ECG intervals (PR, QRS, QT and RR) and death, heart failure and the composite, myocardial infarction (MI), peripheral arterial disease (PAD) or stroke was assessed using Cox proportional hazards models. Multivariate analysis included adjustment for demographics, comorbidities, medications and electrolytes. A sensitivity analysis included an assessment of ECGs among the subgroup without baseline cardiovascular disease (CVD).
Results: After a mean follow-up duration of 5 years, abnormal ECG intervals were associated with an increased incidence of adverse outcomes (Figure 1). The adjusted risk of death was increased among participants with a QRS>100 milliseconds (msec) (HR 1.53 [95%CI 1.21-1.95]), QTc >440 msec (HR 2.15 [95%CI 1.69- 2.74]) and RR<600msec (HR 4.20 [95%CI 1.68-10.51]) compared to participants with a normal QRS, QTc and RR duration, respectively. Abnormal ECG intervals were also independent risk factors for death and the cardiovascular endpoints after excluding participants with prevalent CVD at baseline.
Conclusion: Cardiac conduction disease in CKD participants, including the subgroup without a history of CVD, is strongly associated with an increased risk of adverse outcomes including death. Future studies need to evaluate whether ECG variables can be effective measures for risk stratification in this high risk subgroup of the population.
- © 2012 by American Heart Association, Inc.