Abstract 12962: QRS Duration is Associated With All-Cause Mortality in Type 2 Diabetics: The Diabetes Heart Study

IntroductionQRS duration predicts mortality in patients with heart failure and, to a lesser extent, the general population. However, among diabetic patients, its prognostic significance is unknown. To better understand how QRS duration relates to mortality, we explored survival as a function of QRS duration in the Diabetes Heart Study.HypothesisWe hypothesized that QRS duration would be associated with all-cause mortality among diabetic patients.MethodsThe study population included 1,335 participants with type 2 diabetes. Cox proportional hazards modeling was used to evaluate the relationship between QRS duration and all-cause mortality, comparing those with baseline QRS duration ≤ 120 ms vs. > 120 ms. Multivariable models adjusted for age, sex, race, hypertension, smoking, years with diabetes, body mass index, systolic blood pressure, cholesterol, triglycerides, estimated glomerular filtration rate, and hemoglobin A1c.ResultsParticipants weremean age 61 ± 9 years, 55% women, and 83% white. Participants with baseline QRS duration > 120 ms (n = 99; 7.5%) were older, more likely to be women, had longer duration of diabetes, and had worse kidney function. After 11,000 person-years of follow-up (median 8.5 years; maximum 13.9 years), 266 participants had died (20%). Participants with a baseline QRS duration > 120 ms had an adjusted hazard ratio for all-cause mortality of 1.55 (95% CI 1.06 - 2.22; p = 0.0258). With QRS duration modeled as a continuous variable, we found an 11% increase in risk of death per each 10 ms increase in QRS duration.ConclusionsQRS duration is associated with subsequent all-cause mortality among type 2 diabetics—patients with QRS duration > 120 ms had a 55% increased risk of death, even after adjustment for conventional risk factors. Given the ubiquitous presence of ECG data in the medical record, QRS duration may prove to be a useful prognostic measure, especially among those with diabetes.