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  • Heart Rate-Corrected QT Interval Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Individuals With Type 2 Diabetes: The Diabetes Heart Study

    Author(s)
    Cox, Amanda J.
    Azeem, Amir
    Yeboah, Joseph
    Soliman, Elsayed Z.
    Aggarwal, Shivani R.
    Bertoni, Alain G.
    Carr, J. Jeffrey
    Freedman, Barry I.
    Herrington, David M.
    Bowden, Donald W.
    Griffith University Author(s)
    Cox, Amanda J.
    Year published
    2014
    Metadata
    Show full item record
    Abstract
    OBJECTIVE: Heart rate–corrected QT (QTc) interval is associated with mortality in the general population, but this association is less clear in individuals with type 2 diabetes. We assessed the association of QTc interval with all-cause and cardiovascular disease (CVD) mortality in the Diabetes Heart Study. RESEARCH DESIGN AND METHODS: We studied 1,020 participants with type 2 diabetes (83% European Americans; 55% women; mean age 61.4 years) who were free of atrial fibrillation, major ventricular conduction defects, and antiarrhythmic therapy at baseline. QT duration was automatically calculated from a standard 12-lead ...
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    OBJECTIVE: Heart rate–corrected QT (QTc) interval is associated with mortality in the general population, but this association is less clear in individuals with type 2 diabetes. We assessed the association of QTc interval with all-cause and cardiovascular disease (CVD) mortality in the Diabetes Heart Study. RESEARCH DESIGN AND METHODS: We studied 1,020 participants with type 2 diabetes (83% European Americans; 55% women; mean age 61.4 years) who were free of atrial fibrillation, major ventricular conduction defects, and antiarrhythmic therapy at baseline. QT duration was automatically calculated from a standard 12-lead electrocardiogram (ECG). Following American Heart Association/American College of Cardiology Foundation recommendations, a linear scale was used to correct the QT for heart rate. Using Cox regression, risk was estimated per 1-SD increase in QTc interval as well as prolonged QTc interval (>450 ms) vs. normal QTc interval for mortality. RESULTS: At baseline, the mean (SD) QTc duration was 414.9 ms (18.1), and 3.0% of participants had prolonged QTc. After a median follow-up time of 8.5 years (maximum follow-up time 13.9 years), 204 participants were deceased. In adjusted multivariate models, a 1-SD increase in QTc interval was associated with an 18% higher risk for all-cause mortality (hazard ratio 1.18 [95% CI 1.03–1.36]) and 29% increased risk for CVD mortality (1.29 [1.05–1.59]). Similar results were obtained when QTc interval was used as a categorical variable (prolonged vs. normal) (all-cause mortality 1.73 [0.95–3.15]; CVD mortality 2.86 [1.35–6.08]). CONCLUSIONS: Heart rate QTc interval is an independent predictor of all-cause and CVD mortality in this population with type 2 diabetes, suggesting that additional prognostic information may be available from this simple ECG measure.
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    Journal Title
    Diabetes Care
    Volume
    37
    Issue
    5
    DOI
    https://doi.org/10.2337/dc13-1257
    Subject
    Clinical Sciences not elsewhere classified
    Medical and Health Sciences
    Publication URI
    http://hdl.handle.net/10072/340378
    Collection
    • Journal articles

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