Some common electrocardiogram (EKG) parameters may be able to identify patients with chronic kidney disease (CKD) who are at greater risk for cardiovascular mortality, according to a report published online ahead of print July 9 in the Journal of the American Society of Nephrology.
Rajat Deo, MD, and colleagues evaluated the potential of five EKG parameters—PR interval, QRS duration, corrected QT interval, heart rate, and left ventricular hypertrophy—to predict risk for mortality in 3,939 participants with an estimated glomerular filtration rate (eGFR) that was less than 70 mL/min/1.73 m2. Of these patients, who were followed for a median of 7.5 years, 750 died. After assessing the initial 497 deaths, the researchers identified 256 cardiovascular and 241 noncardiovascular deaths. They found that the five EKG metrics studied were independent risk markers for cardiovascular death.
Hazard ratios (HRs) for specific measures were as follows: a PR interval of 200 ms or greater (HR, 1.62); a QRS interval of 100 ms to 119 ms (HR, 1.64) and 120 ms or greater (HR, 1.75); a corrected QT interval of 450 ms or more in men and 460 ms or more in women (HR, 1.72); and a heart rate of 60 beats per minute (bpm) to 90 bpm (HR, 1.21) and 90 bpm or greater (HR, 2.35). The analysis found that most EKG measures were stronger markers of risk for cardiovascular death than for all-cause mortality or noncardiovascular death, according to the investigators.
“By enhancing the prediction of cardiovascular death in this population, we may find more effective and novel interventions to prevent the complications of cardiovascular disease,” said Dr. Deo.