Age, gender and drug therapy influences on Tpeak-tend interval and on electrical risk score

Background and objectives: Electrical risk score (ERS) has been proposed as easy, inexpensive test to stratify of sudden cardiac death (SCD) risk in subjects with normal left ventricular function. Potentially, aging, gender and drugs can influence ERS affecting two on six electrical markers, particularly, those based on the repolarization. Aim of this study was to establish aging, gender and drug therapy possible influences on ERS and mortality in elderly patients. Method: 237 consecutive, low SCD risk-outpatients with asymptomatic and treated cardiovascular risk factors were analyzed. Six simple ECG markers composed ERS: heart rate (N75 bpm); left ventricular hypertrophy (Sokolow-Lyon criteria); delayed QRS transition zone (≥V4), frontal QRS-T angle (N90°), long QTBazett; long T peak to T end interval (Tp-e). We obtained ERS in 237 outpatients, grouped according age (b40 ys, ≥40 to b60 ys and ≥60 ys), gender and drug therapy with or without possible influence on the repolarization phase. Results: Two-hundred-thirty-seven patients were grouped respectively in the following age classes: b40 years old; ≥40 to b60 years old and ≥60 years old. ERS (p b 0.05), QTBazett (p b 0.001), Tp-e (p b 0.001) were higher in older subjects independently from gender, drug therapy and cardiovascular comorbidity. After two years we reported a 7.3% of mortality in the older groups; age (deceased versus survivors: 80 ± 4 versus 73 ± 7 years, p b 0.05) and Tp-e (deceased versus survivors: 117 ± 15 versus 93 ± 21 ms, p b 0.05) were significantly lower in survivors,multivariable logistic regression analysis selected only the Tp-e as significant risk factor for totalmortality (odd ratio 1.06, 95% CI: 1.01–1.12, p b 0.05). Conclusion: Aging was associated to the ERS and repolarization phase derangement. Tp-e should be considered a marker of total mortality rather than SCD in the over sixty years old patients.