Determinants of Prolonged QT Interval and Their Contribution to Sudden Death Risk in Coronary Artery Disease
Key result
Idiopathic abnormal QTc prolongation was associated with a 5-fold increased odds of sudden cardiac death among patients with coronary artery disease (OR 5.53; 95% CI 3.20 to 9.57).
Why the study?
Does prolonged QTc interval increase the risk of sudden cardiac death in patients with coronary artery disease?
Population
682 patients with coronary artery disease from a metropolitan area of 1,000,000 residents.
Comparison
Prolonged QTc interval vs Normal or borderline QTc interval
Design
Case-control
Authors
Discussion
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Implication
May support QTc monitoring in CAD risk stratification; leaves open whether modification reduces sudden death.
Key Points
- This research investigates the factors contributing to prolonged QT interval and their association with sudden cardiac death risk in patients with coronary artery disease.
- Case-control design comparing SCD patients (N=373) and controls (N=309) with coronary artery disease.
- Mean QTc analysis and determination of risk factors such as gender, diabetes mellitus, and medication use.
- Logistic regression for predicting SCD based on QTc parameters and contributing factors.
- Mean QTc was longer in SCD cases (450±45 ms) compared to controls (433±37 ms; P<0.0001).
- Diabetes mellitus was associated with increased odds of SCD (OR 1.97; 95% CI 1.32-2.96).
- Abnormally prolonged QTc, absent diabetes and QT-prolonging drugs, showed the highest odds of SCD (OR 5.53; 95% CI 3.20-9.57).
Study Design
Type
Case-Control (n=682)
Structured PICO
Does prolonged QTc interval increase the risk of sudden cardiac death in patients with coronary artery disease?
P
Population
682 patients with coronary artery disease (373 cases with sudden cardiac death, 309 controls without sudden cardiac death) from a metropolitan area of 1,000,000 residents.
I
Intervention
Prolonged QTc interval
C
Comparator
Normal or borderline QTc interval
O
Outcome
Sudden cardiac death (SCD)hard clinical
Main Result
Effect estimate: OR 5.53 (95% CI 3.20 to 9.57)
Idiopathic abnormal QTc prolongation is a strong, independent predictor of sudden cardiac death in patients with coronary artery disease, increasing the odds 5-fold.
Cite This Study
Chugh et al. (2009) conducted a case-control in Coronary artery disease (n=682). Prolonged QTc interval vs. Normal or borderline QTc interval was evaluated on Sudden cardiac death (OR 5.53, 95% CI 3.20 to 9.57). Idiopathic abnormal QTc prolongation was associated with a 5-fold increased odds of sudden cardiac death among patients with coronary artery disease (OR 5.53; 95% CI 3.20 to 9.57).