Prolongation of the heart rate-corrected QT interval is associated with cardiovascular diseases: Systematic review and meta-analysis - 17/02/23
, Petra J.M. Elders a, b, Sharon Remmelzwaal a, b, c, Roos Doekhie a, Kok Wai Kee d, Giel Nijpels a, b, Amber A. van der Heijden a, bfor the ESCAPE-NET investigators
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Highlights |
• | QTc prolongation was associated with atrial fibrillation. |
• | QTc prolongation was associated with stroke and sudden cardiac death. |
• | No association was found for myocardial infarction. |
Abstract |
Background |
Conflicting findings have described the association between prolonged heart rate-corrected QT interval (QTc) and cardiovascular disease.
Aims |
To identify articles investigating the association between QTc and cardiovascular disease morbidity and mortality, and to summarize the available evidence for the general and type 2 diabetes populations.
Methods |
A systematic search was performed in PubMed and Embase in May 2022 to identify studies that investigated the association between QTc prolongation and cardiovascular disease in both the general and type 2 diabetes populations. Screening, full-text assessment, data extraction and risk of bias assessment were performed independently by two reviewers. Effect estimates were pooled across studies using random-effect models.
Results |
Of the 59 studies included, 36 qualified for meta-analysis. Meta-analysis of the general population studies showed a significant association for: overall cardiovascular disease (fatal and non-fatal) (hazard ratio [HR] 1.68, 95% confidence interval [CI] 1.33–2.12; I2=69%); coronary heart disease (fatal and non-fatal) in women (HR 1.27, 95% CI 1.08–1.50; I2=38%; coronary heart disease (fatal and non-fatal) in men (HR 2.07, 95% CI 1.26–3.39; I2=78%); stroke (HR 1.59, 95% CI 1.29–1.96; I2=45%); sudden cardiac death (HR 1.60, 95% CI 1.14–2.25; I2=68%); and atrial fibrillation (HR 1.55, 95% CI 1.31–1.83; I2=0.0%). No significant association was found for cardiovascular disease in the type 2 diabetes population.
Conclusion |
QTc prolongation was associated with risk of cardiovascular disease in the general population, but not in the type 2 diabetes population.
Le texte complet de cet article est disponible en PDF.Keywords : Cardiovascular diseases, QT interval, QTc prolongation, ESCAPE-NET, Risk factors
Abbreviations : AF, CHD, CI, CVD, HR, MI, OR, QTc, RR, SCD
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Vol 116 - N° 2
P. 69-78 - février 2023 Retour au numéro
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