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Diabetes Care Publish Ahead of Print published online ahead of print May 7, 2007
DOI: 10.2337/dc07-0063

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Original Research

INCIDENCE AND RISK FACTORS OF PROLONGED QTc INTERVAL IN TYPE 1 DIABETES: THE EURODIAB PROSPECTIVE COMPLICATIONS STUDY.

Sara Giunti, MD1, Graziella Bruno, MD1, Emma Lillaz, MD1, Gabriella Gruden, MD1, Valentina Lolli, MD1, Nish Chaturvedi, MD2, John H. Fuller, MD4, Massimo Veglio, MD3, Paolo Cavallo-Perin, MD1 and The EURODIAB IDDM Complications Study Group

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

graziella.bruno{at}unito.it

ABSTRACT

Objective:QTc prolongation is predictive of cardiovascular mortality in both general and diabetic population. As part of the EURODIAB Prospective Complication Study we have assessed 7-years incidence and risk factors of prolonged QTc in people with type 1 diabetes.

Research Design and Methods:1415 type 1 diabetic subjects, who had normal QTc at baseline, were re-analysed after 7-years follow-up period. QTc>0.44 s was considered abnormally prolonged.

Results:Cumulative incidence of prolonged QTc was 18.7%, two-fold 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 non-incident cases, had higher mean values of systolic blood pressure and HDL-cholesterol, and higher frequencies of hypertension, coronary heart disease and distal symmetrical polyneuropathy. In multivariate logistic regression analysis, female gender and higher values of HbA1c and systolic blood pressure were associated with risk of prolonged QTc, while physical activity and BMI within the range 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 gender, HbA1c and systolic blood pressure are predictive of prolonged QTc, while physical activity and BMI within the range 21.5-23.2 play a protective role. These findings are clinically relevant, as they may help to identify subjects at higher risk for prolonged QTc, providing also potential targets for risk-lowering strategies.


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