HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: dc07-0063v1 30/8/2057    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Giunti, S. Search for Related Content PubMed PubMed Citation Articles by Giunti, S. Social Bookmarking                What's this?

Incidence and Risk Factors of Prolonged QTc Interval in Type 1 Diabetes

The EURODIAB Prospective Complications Study

¹ Department of Internal Medicine, University of Torino, Torino, Italy
² International Centre for Circulatory Health and National Heart and Lung Institute, Imperial College, London, U.K.
³ Department of Epidemiology and Public Health, University College London, London, U.K.
⁴ Ospedale Evangelico Valdese, Torino, Italy

Address correspondence and reprint requests to Prof. Graziella Bruno, Department of Internal Medicine, University of Torino, 14, C.so A.M. Dogliotti, I-10126 Torino, Italy. E-mail: graziella.bruno{at}unito.it

OBJECTIVE—Corrected QT (QTc) prolongation is predictive of cardiovascular mortality in both the general and diabetic populations. As part of the EURODIAB Prospective Complication Study, we have assessed the 7-year incidence and risk factors of prolonged QTc in people with type 1 diabetes.

RESEARCH DESIGN AND METHODS—A total of 1,415 type 1 diabetic subjects, who had normal QTc at baseline, were reanalyzed after the 7-year follow-up period. QTc >0.44 s was considered abnormally prolonged.

RESULTS—Cumulative incidence of prolonged QTc was 18.7%, which is twofold higher in women than in men (24.5 vs. 13.9%, P < 0.0001). At the baseline examination, incident cases were older and less physically active than nonincident cases, had higher mean values of systolic blood pressure and HDL cholesterol, and had higher frequencies of hypertension, coronary heart disease, and distal symmetrical polyneuropathy. In multivariate logistic regression analyses, female sex and higher values of A1C and systolic blood pressure were associated with the risk of prolonged QTc, whereas physical activity and BMI within the range of 21.5–23.2 kg/m² were protective factors. In women, association with modifiable factors, particularly BMI, was stronger than in men.

CONCLUSIONS—In type 1 diabetic subjects from the EURODIAB cohort, female sex, A1C, and systolic blood pressure are predictive of prolonged QTc, whereas physical activity and BMI within the range of 21.5–23.2 kg/m² play a protective role. These findings are clinically relevant, as they may help to identify subjects at higher risk for prolonged QTc, as well as provide potential targets for risk-lowering strategies.

Abbreviations: AER, albumin excretion rate • CHD, coronary heart disease • ECG, electrocardiogram

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				G. Gruden, G. Bruno, N. Chaturvedi, D. Burt, C. Schalkwijk, S. Pinach, C. D. Stehouwer, D. R. Witte, J. H. Fuller, P. C. Perin, et al. Serum Heat Shock Protein 27 and Diabetes Complications in the EURODIAB Prospective Complications Study: A Novel Circulating Marker for Diabetic Neuropathy Diabetes, July 1, 2008; 57(7): 1966 - 1970. [Abstract] [Full Text] [PDF]