Microvolt T-wave alternans at the end of surgery is associated with postoperative mortality in cardiac surgery patients

Chang Hoon Koo, Hyung Chul Lee, Tae Kyong Kim, Youn Joung Cho, Karam Nam, Eue Keun Choi, Sheung Nyoung Choi, Sehee Yoon, Yunseok Jeon

Research output: Contribution to journalArticle

Abstract

Microvolt T-wave alternans (MTWA), which reflects electrical dispersion of repolarization, is known to be associated with arrhythmia or sudden cardiac death in high risk patients. In this study we investigated the relationship between MTWA and postoperative mortality in 330 cardiac surgery patients. Electrocardiogram, official national data and electric chart were analysed to provide in-hospital and mid-term outcome. MTWA at the end of surgery was significantly associated with in-hospital mortality in both univariate analysis (OR = 27.378, 95% CI 5.616–133.466, p < 0.001) and multivariate analysis (OR = 59.225, 95% CI 6.061–578.748, p < 0.001). Cox proportional hazards model revealed MTWA at the end of surgery was independently associated with mid-term mortality (HR = 4.337, 95% CI 1.594–11.795). The area under the curve of the model evaluating MTWA at the end of surgery was 0.764 (95% CI, 0.715–0.809) and it increased to 0.929 (95% CI, 0.896–0.954) when combined with the EuroSCORE II. MTWA positive at the end of surgery had a 60-fold increase in in-hospital mortality and a 4-fold increase in mid-term mortality. Moreover, MTWA at the end of surgery could predict in-hospital mortality and this predictability is more robust when combined with the EuroSCORE II.

Original languageEnglish
Article number17351
JournalScientific Reports
Volume9
Issue number1
DOIs
StatePublished - 1 Dec 2019

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Thoracic Surgery
Hospital Mortality
Mortality
Sudden Cardiac Death
Proportional Hazards Models
Area Under Curve
Cardiac Arrhythmias
Electrocardiography
Multivariate Analysis

Cite this

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title = "Microvolt T-wave alternans at the end of surgery is associated with postoperative mortality in cardiac surgery patients",
abstract = "Microvolt T-wave alternans (MTWA), which reflects electrical dispersion of repolarization, is known to be associated with arrhythmia or sudden cardiac death in high risk patients. In this study we investigated the relationship between MTWA and postoperative mortality in 330 cardiac surgery patients. Electrocardiogram, official national data and electric chart were analysed to provide in-hospital and mid-term outcome. MTWA at the end of surgery was significantly associated with in-hospital mortality in both univariate analysis (OR = 27.378, 95{\%} CI 5.616–133.466, p < 0.001) and multivariate analysis (OR = 59.225, 95{\%} CI 6.061–578.748, p < 0.001). Cox proportional hazards model revealed MTWA at the end of surgery was independently associated with mid-term mortality (HR = 4.337, 95{\%} CI 1.594–11.795). The area under the curve of the model evaluating MTWA at the end of surgery was 0.764 (95{\%} CI, 0.715–0.809) and it increased to 0.929 (95{\%} CI, 0.896–0.954) when combined with the EuroSCORE II. MTWA positive at the end of surgery had a 60-fold increase in in-hospital mortality and a 4-fold increase in mid-term mortality. Moreover, MTWA at the end of surgery could predict in-hospital mortality and this predictability is more robust when combined with the EuroSCORE II.",
author = "Koo, {Chang Hoon} and Lee, {Hyung Chul} and Kim, {Tae Kyong} and Cho, {Youn Joung} and Karam Nam and Choi, {Eue Keun} and Choi, {Sheung Nyoung} and Sehee Yoon and Yunseok Jeon",
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AU - Lee, Hyung Chul

AU - Kim, Tae Kyong

AU - Cho, Youn Joung

AU - Nam, Karam

AU - Choi, Eue Keun

AU - Choi, Sheung Nyoung

AU - Yoon, Sehee

AU - Jeon, Yunseok

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