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Impact of Diabetes on QT Dynamicity in Patients With and Without Myocardial Infarction: The KORA Family Heart Study
Author(s) -
LIEB WOLFGANG,
VOSS CHRISTIAN,
ORTAK JASMIN,
BARANTKE MELANIE,
HENGSTENBERG CHRISTIAN,
LOEWEL HANNELORE,
HOLMER STEPHAN,
ERDMANN JEANETTE,
SCHUNKERT HERIBERT,
BONNEMEIER HENDRIK
Publication year - 2007
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2007.00634.x
Subject(s) - medicine , cardiology , myocardial infarction , diabetes mellitus , qt interval , sudden cardiac death , population , incidence (geometry) , endocrinology , physics , environmental health , optics
Patients with diabetes mellitus (DM) have an unfavorable prognosis after myocardial infarction (MI), partially due to a higher risk of sudden cardiac death (SCD). QT dynamicity is an independent predictor of SCD in post‐MI patients. However, the effects of diabetes on QT dynamicity in patients with MI have not been described.Methods: We studied 468 survivors of MI (67 with DM) from the population‐based MONICA registry (KORA Family Heart Study), Augsburg, Germany, by standardized questionnaire, anthropometry, electrocardiogram (ECG), 30‐minute‐Holter‐ECG‐recordings and echocardiography. In addition, 422 siblings without prior MI (22 with DM) were studied by the same protocol.Results: Among post‐MI patients, the QT/RR slope was significantly steeper in diabetics than in nondiabetics (0.096 ± 0.057 vs 0.077 ± 0.045; P = 0.002). Likewise, among siblings without MI, the QT/RR slope was steeper in diabetics than in nondiabetics (0.104 ± 0.053 vs 0.080 ± 0.042; P = 0.008). The association of DM with steeper QT/RR slope remained significant in multivariate models in post‐MI patients (β: −0.14; P = 0.004) as well as in individuals without MI (β: −0.10; P = 0.047).Conclusions: In a large population of survivors of MI and unaffected siblings, patients and siblings presenting with DM exhibited an abnormal QT rate‐dependence, compared with individuals without DM in both groups. Thus, diabetes itself may be a major determinant of ventricular arrhythmias, independently of a previous MI. These observations might in part explain the higher incidence of sudden cardiac death and ventricular arrhythmias in patients with DM.