Key result
Young patients with long QT syndrome and a past history of cardiac events had a significantly higher rate of new events after diagnosis compared to those without a past history (47% vs 5%).
Why the study?
What are the risk factors for new cardiac events in young patients with long QT syndrome?
Cohort (n=197)
Yes
What are the risk factors for new cardiac events in young patients with long QT syndrome?
Absolute Event Rate: 47% vs 5%
p-value: p=<0.0001
In young patients with LQTS, a prior history of cardiac events strongly predicts future events, highlighting the critical need for medication compliance, while an LQTS score <4 reliably predicts the absence of events in those without a prior history.
May aid risk stratification in young LQTS patients; hypothesis-generating and requires prospective validation.
The objective of this study was to determine who is at risk for cardiac events among young patients with long QT syndrome (LQTS) with or without a past history of LQTS-related cardiac events. The subjects were young patients with LQTS who had visited one of 36 hospitals from January 1997 to August 2000 in Japan. To predict the risk factors for cardiac events, stepwise regression analyses were performed for a total of 197 cases. There were 7 of 129 cases (5%) without a past history and 32 of the 68 (47%) cases with a past history of LQTS-related cardiac events that experienced new events after diagnosis (p<0.0001). Patients with a family history showed a higher incidence of symptoms both before and after diagnosis than patients with sporadic occurrence. Analyses revealed that noncompliance with medication and a lower age at diagnosis were significant predictors for the group with a past history. A negative predictive value <4 points was 100% in the group without a past history. To prevent future cardiac events, compliance with medication must be improved in those with a past history. A total LQTS score <4 points was useful to predict the absence of cardiac events in the group without a past history.
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Yoshinaga et al. (2003) conducted a cohort in Long QT syndrome (LQTS) (n=197). Past history of LQTS-related cardiac events vs. No past history of LQTS-related cardiac events was evaluated on New LQTS-related cardiac events after diagnosis (p=<0.0001). Young patients with long QT syndrome and a past history of cardiac events had a significantly higher rate of new events after diagnosis compared to those without a past history (47% vs 5%).
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