Heart failure & cardiomyopathies
Noninvasive risk assessment and prediction of cardiac outcomes in patients with congestive heart failure or myocardial infarction
Authors' conclusion
The K-REDEFINE study identified abnormal HRT, mostly assessed within 1 month after hospitalization, as a significant predictor not only for cardiac death and ventricular tachyarrhythmia but also for HFH.
Study context
- Population
- Patients with acute myocardial infarction (MI) or heart failure (HF) in South Korea (age 60.8 ± 2.9 years; 76.3% male); 24-hour Holter within 6.8 ± 16.5 days after hospitalization
- Participants
- 1,116 patients
- Exposure
- Abnormal vs normal heart rate turbulence (HRT) and T-wave alternans (TWA) for prediction of adverse cardiac events
- Outcome
- Composite of:
- Cardiac death
- Ventricular tachyarrhythmias
- HF-related hospitalization (HFH)
- Follow-up
- 4.3 ± 1.2 years
Methodological detailsobservational, multicenter, 26 tertiary hospitals in South Korea
- Observational
- Multicenter
- 26 tertiary hospitals in South Korea
Main finding
As reported in the abstract
Composite outcome · 4.3 ± 1.2 years
Adjusted hazard ratio (95% CI)
Impaired HRT
3.41(2.27–5.13)
Abnormal TWA
1.51(1.06–2.16)
Observational data: associations, not effects.
Further findings
Individual events with impaired HRT
| Comparison | aHR (95% CI) | |
|---|---|---|
| Impaired HRTCardiac death | 4.08 (2.17–7.70) | |
| Impaired HRTVentricular tachyarrhythmia | 3.72 (1.29–10.77) | |
| Impaired HRTHFH | 4.32 (2.25–8.28) | |
| 0.050.21520Adjusted hazard ratio (log scale) |
- Abnormal TWA significantly associated only with the composite outcome
Abnormal HRT by subgroup (MI, HF, ejection fraction (EF))
- Predictive power consistently significant across MI and HF subgroups and varying EF; further enhanced when combined with reduced EF (<50%)
Original publication
Noninvasive risk assessment and prediction of cardiac outcomes in patients with congestive heart failure or myocardial infarction. Heart Rhythm. Published 10 October 2024. doi:10.
Summarised from the published abstract; every number is checked against it