645-P: QTc Prolongation as a Risk Factor for Five-Year Survival after Above-Ankle Amputation in Patients with Type 2 Diabetes

Abstract

Patients with diabetic foot ulcers (DFU) are considered high-risk individuals for increased cardiovascular disease and mortality. After a major amputation the mortality risk is even higher, with five-year mortality rates exceeding 70%. QTc interval prolongation is a potential indicator of increased cardiovascular risk in the general population as well as in patients with diabetes. The aim of this study was to evaluate the impact of QTc prolongation on 5-years survival after above ankle amputation in patients with type 2 diabetes. We retrospectively enrolled all patients (n=97) with type 2 diabetes, not older than 85 years without a pacemaker, who underwent a major amputation at two hospitals with multidisciplinary DFU teams. Patients were grouped according to QTc time ≤ or >440 ms. Mortality data after 5 years was obtained from the Swedish National Death Registry. Non-parametric statistics were used when assessing differences and survival was analyzed with Kaplan-Meier estimates with log-rank test. As shown in the Figure, QTc prolongation was significantly associated with worse survival (82 vs. 57% 5-year mortality). Presence of ischemic heart disease, age and diabetes duration did not differ between groups. In conclusion, we have demonstrated that routinely ECG screening with QT interval analysis in a DFU-population, provides important information regarding long-term survival. Disclosure S. Puvaneswaralingam: None. K. Fagher: Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. M. Londahl: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. Funding Craaford Foundation; Krapperyp Foundation; County of Skåne Foundation; Diabetes Foundation