Abstract
BackgroundThe risk stratification of coronary heart disease (CHD) and/or heart failure (HF) patients with easily measured electrocardiographic markers is of clinical importance. The aim of this meta‐analysis is to indicate whether increased QT dispersion (QTd) is associated with fatal and nonfatal outcomes in patients with CHD and/or HF.MethodsWe systematically searched MEDLINE and Cochrane databases without restrictions until August 15, 2018 using the keyword “QT dispersion”. Studies including data on the association between QTd and all‐cause mortality, sudden cardiac death (SCD) or arrhythmic events in patients with HF and/or CHD were classified as eligible.ResultsIn the analysis including patients with CHD and/or HF, we found that QTd did not differ significantly in patients with SCD compared to no SCD patients while QTd was significantly greater in the group of all‐cause mortality patients and in patients who experienced a sustained ventricular arrhythmia. Subgroup analysis showed that in myocardial infarction studies, QTd was significantly higher in patients with an arrhythmic event compared to arrhythmic event‐free patients while a nonsignificant difference was found in QTd in patients who died from any cause compared to survivors. Similarly, in HF patients, the QTd was significantly greater in patients with an arrhythmic event while a nonsignificant difference was found regarding all‐cause mortality and SCD outcomes.ConclusionsQTd has a prognostic role for stratifying myocardial infarction or HF patients who are at higher risk of arrhythmic events. However, no prognostic role was found regarding all‐cause mortality or SCD in this patient population.
Highlights
The identification of patients at increased risk for sudden cardiac death (SCD) and major arrhythmic events [ventricular fibrillation (VF) and ventricular tachycardia (VT)] is of outstanding clinical im‐ portance
In order to aggregate diverging evidence in the field, we performed a quantitative synthesis of the existing data about the impact of QT dispersion (QTd) on three major outcomes in patients coronary heart disease (CHD) and/or heart fail‐ ure (HF)
The studies included in our meta‐analysis presented data concern‐ ing the association between QTd and all‐cause mortality, SCD or arrhythmic events in patients with HF or with CHD
Summary
The identification of patients at increased risk for sudden cardiac death (SCD) and major arrhythmic events [ventricular fibrillation (VF) and ventricular tachycardia (VT)] is of outstanding clinical im‐ portance. In order to aggregate diverging evidence in the field, we performed a quantitative synthesis of the existing data about the impact of QTd on three major outcomes (all‐cause mortality, SCD, and arrhythmic events) in patients CHD and/or HF
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