Clinical outcomes according to QRS duration and morphology in the Eplerenone in Mild Patients: Hospitalization and SurvIval Study in Heart Failure (EMPHASIS-HF)

Cannon, J. A. (author)

Collier, T. J. (author)

Shen, L. (author)

Swedberg, Karl, 1944 (author): Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine

Krum, H. (author)

van Veldhuisen, D. J. (author)

Vincent, J. (author)

Pocock, S. J. (author)

Pitt, B. (author)

Zannad, F. (author)

McMurray, J. J. V. (author)

(creator_code:org_t)

2015-07-03
2015
English.
In: European Journal of Heart Failure. - : Wiley. - 1388-9842. ; 17:7, s. 707-716

Related links:: https://onlinelibrar...; show more...; https://gup.ub.gu.se...; https://doi.org/10.1...; show less...

Abstract Subject headings

AimsWe examined the relationship between different degrees of QRS prolongation and different QRS morphologies and clinical outcomes in patients with heart failure, reduced ejection fraction (HF-REF), and mild symptoms in the Eplerenone in Mild Patients Hospitalization and SurvIval Study in Heart Failure trial (EMPHASIS-HF). We also evaluated the effect of eplerenone in these patients according to QRS duration/morphology. Methods and resultsPatients were categorized as: QRS duration (ms) (i) <120 (n = 1375); (ii) 120-149 (n = 517); and (iii) 150 (n = 383), and QRS morphology (i) normal (n = 1252); (ii) left bundle branch block (BBB) (n = 608); and (iii) right BBB/intraventricular conduction defect (IVCD) (n = 415). The outcomes examined were the composite of cardiovascular death or heart failure hospitalization and all-cause mortality. Both abnormal QRS duration and QRS morphology were associated with higher risk, e.g. the rates of the composite outcome were: 10.2, 17.6, and 15.5 per 100 patient-years in the <120, 120-149, and 150ms groups, respectively. Eplerenone reduced the risk of the primary outcome and mortality, compared with placebo, consistently across the QRS duration/morphology subgroups. ConclusionWe found that even moderate prolongation of QRS duration and right BBB/IVCD were associated with a high risk of adverse outcomes in HF-REF. Eplerenone was similarly effective, irrespective of QRS duration/morphology.

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

By the author/editor: Cannon, J. A.; Collier, T. J.; Shen, L.; Swedberg, Karl, ...; Krum, H.; van Veldhuisen, ...; show more...; Vincent, J.; Pocock, S. J.; Pitt, B.; Zannad, F.; McMurray, J. J. ...; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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