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Prognostic Potential of Electrocardiographic Parameters in Patients with Multiple Myeloma: A Retrospective Analysis of the Multiple Myeloma Population

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Abstract

Introduction

Patients with multiple myeloma (MM) can develop cardiac abnormalities, predisposing them to the development of heart failure, arrhythmias, or infarction with poor prognosis. The purpose of this study is to evaluate the prognostic potential of electrocardiographic (ECG) parameters in patients with MM.

Methods

This study retrospectively included patients with MM from January 2010 to December 2018 in the First Affiliated Hospital of Xi’an Jiao Tong University. Univariate and multivariate Cox proportional hazard models were conducted to evaluate the relationship between ECG parameters and all-cause mortality in patients with MM.

Results

A total of 409 patients were included (mean age 61.3 ± 9.7 years, 59.2% male). The relationship between ECG parameters (including PR interval, voltage, QRS axis, QRS duration, and QTc interval) and all-cause mortality in patients with MM was evaluated. Overall, patients with QTc interval ≥ 400 ms have a significantly higher all-cause mortality compared to those with QTc interval < 400 ms (P < 0.001). When stratified by the International Staging System (ISS), this relationship was true for stages II and III (P < 0.01), but not stage I (P > 0.05). Patients with MM and QRS duration ≥ 120 ms had a higher all-cause mortality compared to those with QRS duration < 120 ms for women (P < 0.01) but not for men (P > 0.05). PR interval, voltage, and QRS axis did not predict mortality.

Conclusion

QTc interval was independently associated with all-cause mortality in patients with MM, especially when QTc interval was more than 400 ms in more advanced stages II and III. ECG parameters may provide prognostic potential in patients with MM and aid risk stratification of these patients.

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Acknowledgements

We thank the participants of the study.

Funding

This study was funded by the Clinical Research Program of the First Affiliated Hospital of Xi’an Jiaotong University of China (XJTU1AF-CRF-2018-015). The journal’s Rapid Service Fee was funded by the authors.

Authorship

All authors contributed to drafting the manuscript, reviewing the manuscript content critically, and designing and implementation of the research. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Jie Wang, Jiaqi An, Gary Tse, Pengcheng He, Haibo Liu, Aifeng Zhang, Guoliang Li, Yongxin Li, Chaofeng Sun and Yang Yan have nothing to disclose.

Compliance with Ethics Guidelines

This study analysis was conducted in accordance with the 1964 declaration of Helsinki and its later amendments and was approved by the Ethic Committee of the First Affiliated Hospital of Xi’an Jiao Tong University. Informed consent with consent to use clinical data for research purposes was obtained from all patients or relatives.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. Jie Wang and Jiaqi An contributed equally to this work and should be considered to share first authorship.

Authors and Affiliations

  1. Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, 710061, Shaanxi, China

    Jie Wang, Pengcheng He & Haibo Liu

  2. Atrial Fibrillation Centre and Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, 710061, Shaanxi, China

    Jiaqi An, Guoliang Li & Chaofeng Sun

  3. Stroke Centre and Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, 710061, Shaanxi, China

    Jiaqi An

  4. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China

    Gary Tse

  5. Renal Division, Brigham and Women’s Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA, 02115, USA

    Aifeng Zhang

  6. Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, 710061, Shaanxi, China

    Yongxin Li & Yang Yan

Authors
  1. Jie Wang
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  2. Jiaqi An
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  3. Gary Tse
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  7. Guoliang Li
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  9. Chaofeng Sun
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  10. Yang Yan
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Corresponding authors

Correspondence to Chaofeng Sun or Yang Yan.

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Wang, J., An, J., Tse, G. et al. Prognostic Potential of Electrocardiographic Parameters in Patients with Multiple Myeloma: A Retrospective Analysis of the Multiple Myeloma Population. Adv Ther 37, 2946–2955 (2020). https://doi.org/10.1007/s12325-020-01343-9

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  • DOI: https://doi.org/10.1007/s12325-020-01343-9

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