What question did this study set out to answer?

To determine whether reduced heart rate variability, prolonged corrected QT (QTc) interval, or increased QT dispersion predict all-cause mortality in diabetic and nondiabetic adults.

February 27, 2008Diabetes CareOpen Access

Prediction of Mortality Using Measures of Cardiac Autonomic Dysfunction in the Diabetic and Nondiabetic Population

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Why the study?

Do measures of cardiac autonomic dysfunction (prolonged QTc interval, reduced heart rate variability, or increased QT dispersion) predict all-cause mortality in diabetic and nondiabetic populations?

Key Points

To determine whether reduced heart rate variability, prolonged corrected QT (QTc) interval, or increased QT dispersion predict all-cause mortality in diabetic and nondiabetic adults.
Prospective cohort study analyzing 1,560 nondiabetic and 160 diabetic participants aged 55–74 years over a 9-year follow-up.
Assessed baseline 20-second resting 12-lead ECGs for lowest quartile max-min R-R interval difference, prolonged QTc (>440 ms), and increased QT dispersion (>60 ms).
Multivariate Cox proportional hazard models evaluated all-cause mortality adjusting for demographic variables and cardiovascular risk factors.
Over the 9-year follow-up, 10.5% of nondiabetic and 30.6% of diabetic participants died.
In nondiabetic subjects, prolonged QTc predicted mortality (HR 2.02 [95% CI 1.29–3.17]; P = 0.002), whereas low max-min (HR 0.93 [95% CI 0.65–1.34]; P = 0.700) and increased QT dispersion (HR 0.98 [95% CI 0.60–1.60]; P = 0.939) did not.
In diabetic subjects, prolonged QTc independently predicted mortality (HR 3.00 [95% CI 1.34–6.71]; P = 0.007), low max-min showed an increased risk trend (HR 1.74 [95% CI 0.95–3.18]; P = 0.075), and increased QT dispersion showed no association (HR 0.42 [95% CI 0.06–3.16]; P = 0.402).

Structured PICO

Do measures of cardiac autonomic dysfunction (prolonged QTc interval, reduced heart rate variability, or increased QT dispersion) predict all-cause mortality in diabetic and nondiabetic populations?

Population

1,720 subjects aged 55-74 years, comprising nondiabetic (n=1,560) and diabetic (n=160) individuals.

Intervention

Prolonged QTc interval (>440 ms), reduced heart rate variability (lowest quartile max-min R-R interval), and increased QT dispersion (>60 ms)

Comparator

Normal QTc interval (≤440 ms), normal heart rate variability, and normal QT dispersion (≤60 ms)

Outcome

All-cause mortality at 9-year follow-uphard clinical

Prolonged QTc interval is an independent predictor of all-cause mortality in both diabetic and nondiabetic older adults, whereas QT dispersion is not.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May inform mortality risk stratification in older adults; hypothesis-generating and requires prospective validation before changing practice.

Cite This Study

Ziegler et al. (2008) studied this question.

synapsesocial.com/papers/6a7cc8674f6c5ab12328aba9 https://doi.org/10.2337/dc07-1615

Topics

Women and heart disease

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Implication

May inform mortality risk stratification in older adults; hypothesis-generating and requires prospective validation before changing practice.

Prediction of Mortality Using Measures of Cardiac Autonomic Dysfunction in the Diabetic and Nondiabetic Population

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Prediction of Mortality Using Measures of Cardiac Autonomic Dysfunction in the Diabetic and Nondiabetic Population

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider