Document Detail


Long QT syndrome in patients over 40 years of age: increased risk for LQTS-related cardiac events in patients with coronary disease.
MedLine Citation:
PMID:  18973489     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous studies of long QT syndrome (LQTS) have focused primarily on the clinical course of affected patients up to 40 years of age to avoid the confounding influence of acquired heart disease on LQTS-related cardiac events in this genetic disorder.
METHODS: Patients were identified as having coronary disease if they had a history of hospitalization for myocardial infarction, coronary angioplasty, coronary artery bypass graft surgery, or were treated with medication for angina. LQTS-related cardiac events included the first occurrence of syncope, aborted cardiac arrest, or sudden cardiac death without evidence suggestive of an acute coronary event. Cox proportional hazards regression modeling was used to analyze the independent contribution of coronary disease to LQTS-related cardiac events.
RESULTS: Time-dependent coronary disease was associated with an increased risk of LQTS-related cardiac events (hazard ratio 2.24, 95% confidence interval 1.23-4.07, P = 0.008) after adjustment for syncopal history before age 40, QTc, and gender. Factors such as diabetes and hypertension that increase the risk for coronary disease were not associated with an increased risk for LQTS-related cardiac events.
CONCLUSIONS: This is the first study to demonstrate that coronary disease augments the risk for LQTS-related cardiac events in LQTS. The findings highlight the need for more focused preventive therapy in LQTS patients above the age of 40.
Authors:
Edward Sze; Arthur J Moss; Ilan Goldenberg; Scott McNitt; Christian Jons; Wojciech Zareba; Ming Qi; Jennifer L Robinson;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  13     ISSN:  1542-474X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-31     Completed Date:  2009-02-12     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  327-31     Citation Subset:  IM    
Affiliation:
Cardiology Division, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642-8653, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Adult
Aged
Aged, 80 and over
Death, Sudden, Cardiac / etiology*
Female
Heart Arrest / etiology*
Humans
Long QT Syndrome / complications*,  therapy
Male
Middle Aged
Risk Factors
Syncope / etiology*
Grant Support
ID/Acronym/Agency:
HL-33843/HL/NHLBI NIH HHS; HL-51618/HL/NHLBI NIH HHS; R01 HL033843-20A1/HL/NHLBI NIH HHS; R01 HL051618-10/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists
Investigator
Investigator/Affiliation:
Michael J Ackerman / ; Jesaia Benhorin / ; Elizabeth Kaufman / ; Emanuela Locati / ; Carlo Napolitano / ; Silvia Priori / ; Peter J Schwartz / ; Carla Spazzolini / ; Jeffrey Towbin / ; G Michael Vincent / ; Li Zhang /
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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