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Longer QRS Duration Predicts Cardiac Death, Heart Attack

Posted on Sun, Oct 25, 2015
Longer QRS Duration Predicts Cardiac Death, Heart Attack

Findings in patients with known, suspected coronary artery disease

Longer QRS duration predicts cardiac death and nonfatal myocardial infarction (MI) in patients with coronary artery disease, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.

Roy Huurman, from Erasmus Medical Center in the Netherlands, and colleagues investigated the long-term prognostic value of QRS duration in 512 patients (308 men) with known or suspected coronary artery disease who underwent myocardial perfusion imaging (MPI).

The researchers found that over a mean follow-up of 8.6 years, 290 patients died (60 percent), with 27 percent of these deaths attributable to cardiac causes. Twenty-eight patients (6 percent) had nonfatal MI, and 127 patients (25 percent) underwent late coronary revascularization (>three months). The annualized cardiac death rates and cardiac death or nonfatal MI rates were lower in patients with QRS duration <120 ms compared with those with QRS duration of ≥120 ms (2.2 percent and 2.3 percent, respectively, versus 4.1 percent and 4.4 percent, respectively). In multivariate models, QRS duration ≥120 ms was an independent predictor of both end points, in addition to clinical characteristics and MPI results.

"In conclusion, QRS duration ≥120 ms is an independent predictor of cardiac death and cardiac death or nonfatal MI, after adjustment for clinical characteristics and MPI results," write the authors.

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Cardiovascular Risk Up After Knee, Hip Replacement

Posted on Sun, Sep 06, 2015
Cardiovascular Risk Up After Knee, Hip Replacement

Odds highest in the month following the procedure

WEDNESDAY, Sept. 2, 2015 (HealthDay News) -- Patients who have total hip or knee replacement surgery face a greater risk for myocardial infarction (MI) during the first month following the procedure, according to research published online Aug. 31 in Arthritis & Rheumatology.

Yuqing Zhang, D.Sc., a professor of medicine and epidemiology at the Boston University School of Medicine, and colleagues collected data on 13,849 people over the age of 50 with osteoarthritis who had a total knee replacement. They compared these patients with a similar number of people who didn't have the procedure. They also collected data on 6,063 people over the age of 50 with osteoarthritis who had a total hip replacement and compared them with a similar number of people who didn't have one.

The risk of MI was more than eight times greater in the first 30 days after total knee replacement surgery compared to that seen in people who didn't have the procedure. The risk of MI was four times greater during the month following total hip replacement surgery. The odds of MI dissipated over time in these patients, the researchers found. However, the odds of venous thromboembolism increased in the month following surgery and lasted for years after knee or hip replacement was performed.

"Contrary to recently published findings, our study indicates that total joint replacement procedures do not provide an overall protective effect on the risk of heart attack," Zhang told HealthDay.

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