Serum total p-cresylsulfate level is associated with abnormal QTc interval in stable angina patients with early stage of renal failure

• Relationship of electrocardiogram parameter and the uremic retention toxin p-cresylsulfate (PCS) was evaluated.
• Patients with abnormal corrected QT interval were found to have higher serum PCS levels.
• PCS was found independently associated with QTc prolongation in multivariate and trend analysis.
• PCS was significantly associated with major adverse cardiac events and death in patient follow-up.
• Further investigation in PCS arrhythmogenic effect is warranted.

Backgroundp-Cresylsulfate (PCS), a protein-bound uraemic retention solute, is known to cause endothelial dysfunction and possibly plays a role in coronary atherosclerosis. Furthermore, the association among serum total PCS, major adverse cardiovascular events, and all-cause mortality were also found in previous studies. However, little is known about the relationship between total PCS level and prolonged QT interval. We assessed whether serum total PCS level is related with prolonged QT interval by measuring 12-lead electrocardiogram (ECG) recording in stable angina patients with early stage of renal failure.MethodsSerum total PCS concentrations were measured by using the Ultra Performance LC System in 154 consecutive stable angina patients. A 12-lead ECG recording was obtained from each subject.ResultsPatients with abnormal corrected QT (QTc) interval have higher median serum total PCS levels than patients with normal QTc interval. Statistically significant associations were observed between the serum total PCS levels and the QTc interval (r = 0.217, P = 0.007). Using multivariate and trend analyses, serum total PCS level was independently associated with QTc prolongation.ConclusionsThis study indicates that serum total PCS levels are significantly higher in the presence of abnormal QTc interval and are associated with the QTc prolongation. Whether total PCS plays a role in the pathogenesis of QTc prolongation requires future investigation.