What is the clinical evidence from this study?

Study design: Cohort. Population: Type 1 and Type 2 Diabetes Mellitus (n=179). Intervention: Type 1 and Type 2 Diabetes vs. Baseline (first visit). Primary outcome: Change in left ventricular ejection fraction (LVEF) from first to second visit in Type 2 diabetes (p=<0.001).

What does this research mean for the field?

Prolonged QTc is highly prevalent in hospitalized diabetic patients and correlates with a significant reduction in left ventricular ejection fraction over time. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

April 3, 2017Journal of Community Hospital Internal Medicine PerspectivesOpen Access

Prevalence of QT prolongation and associated LVEF changes in diabetic patients over a four-year retrospective time period

Q: What are the key findings of this study?

In hospitalized patients with diabetes, prolonged QTc was highly prevalent (66.7% in Type 1, 51.3% in Type 2), and Type 2 diabetes was associated with a significant reduction in LVEF over 17.3 months.

Q: What does this research mean for the field?

Prolonged QTc is highly prevalent in hospitalized diabetic patients and correlates with a significant reduction in left ventricular ejection fraction over time. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Type 2 diabetes linked to an absolute ~7% decline in LVEF among hospitalized patients.

P<0.001
n=179

Population

179 hospitalized patients with Type 1 or Type 2 diabetes mellitus with at least two admissions during a…

Design

Cohort

Follow-up

median 20.5 months for type 1 DM and 17.3 months for type…

Authors

ZLZhongju LuStony Brook School LLLloyd LenseStony Brook University Hospital MSMohit Sharma

Discussion

Member takes

Implication

Frequent QTc prolongation in diabetic inpatients warrants vigilance; leaves open whether it predicts LVEF reduction prospectively.

Study Design

Type

Cohort (n=179)

Multicenter

Structured PICO

Population

179 hospitalized patients with Type 1 or Type 2 diabetes, aged 20 to 90 years, followed for a median of 17 to 20 months to evaluate QTc prolongation and LVEF changes.

Outcome

Prevalence of prolonged QTc interval and longitudinal changes in QTc and LVEF between hospital admissionssurrogate

Main Result

Absolute Event Rate: 55.5% vs 62.4%

p-value: p=<0.001

Hospitalized patients with diabetes exhibit a high prevalence of QTc prolongation, which is associated with a significant reduction in LVEF over a short follow-up period in type 2 diabetes.

Limitations

Retrospective study design cannot determine temporal or causal relationships between risk factors and QTc prolongation.
Single community hospital setting introduces potential selection bias.
Did not adjust for the use of beta blockers which are known to affect LVEF.
Small number of type 1 diabetic patients and short follow-up period limited statistical power.
Intrinsic slight inaccuracies of methods for measuring LVEF by TTE and routine physiological variations.
Retrospective study design cannot determine temporal or causal relationships
Single community hospital setting with potential for selection bias
Inability to specifically adjust for beta blocker use
Intrinsic inaccuracies of LVEF measurement by TTE
Small numbers of type 1 diabetic patients and short follow-up period

Cite This Study

Lu et al. (2017) conducted a cohort in Type 1 and Type 2 Diabetes Mellitus (n=179). Type 1 and Type 2 Diabetes vs. Baseline (first visit) was evaluated on Change in left ventricular ejection fraction (LVEF) from first to second visit in Type 2 diabetes (p=<0.001). In hospitalized patients with diabetes, prolonged QTc was highly prevalent (66.7% in Type 1, 51.3% in Type 2), and Type 2 diabetes was associated with a significant reduction in LVEF over 17.3 months.

synapsesocial.com/papers/6a19bcd37081f56b37df019c https://doi.org/10.1080/20009666.2017.1320203

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Prevalence of QT prolongation and associated LVEF changes in diabetic patients over a four-year retrospective time period

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Prevalence of QT prolongation and associated LVEF changes in diabetic patients over a four-year retrospective time period

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider