Key result
The presence of coronary artery disease in patients with type 2 diabetes was an independent predictor of increased ventricular repolarization dynamics (HR 4.4).
Why the study?
Does the presence of coronary artery disease alter ventricular repolarization dynamics in patients with type 2 diabetes?
Case-Control (n=76)
Double-blind
No
Does the presence of coronary artery disease alter ventricular repolarization dynamics in patients with type 2 diabetes?
Hazard Ratio: 4.4 (95% CI 1.4–13.7)
p-value: p=0.008
Ventricular repolarization abnormalities in patients with type 2 diabetes appear to be driven by the presence of silent coronary artery disease rather than diabetes itself.
May indicate silent CAD drives repolarization issues in T2D; hypothesis-generating, should not yet change practice.
Ventricular repolarization dynamics (VRD) is an important predictor of outcome in diabetes. We examined the potential impact of coronary artery disease (CAD) on VRD in type 2 diabetic patients. We recorded 5-minute high-resolution resting electrocardiograms in 38 diabetic patients undergoing elective coronary angiography, and in 38 age- and gender-matched apparently healthy subjects (controls). Using leads-I and -II, time-domain indices of VRD were calculated. Coronary angiography was regarded as positive if >/= 50% stenosis was found. Angiography was positive in 21 diabetic patients (55%). Patients with CAD had a significantly higher degree of VRD than controls (SDNN(QT): 15.81 +/- 7.22 ms versus 8.94 +/- 6.04 ms; P < 0.001, rMSSD(QT): 21.02 +/- 7.07 ms versus 11.18 +/- 7.45 ms; P < 0.001). Ventricular repolarization dynamics in diabetic patients with negative angiograms did not differ from VRD in controls (SDNN(QT): 8.94 +/- 6.04 ms versus 7.44 +/- 5.72 ms; P = 0.67, rMSSD(QT): 11.18 +/- 7.45 ms versus 10.22 +/- 5.35 ms; P = 0.82). CAD increases VRD in patients with type 2 diabetes. Therefore, changes in ventricular repolarization in diabetic patients may be due to silent CAD rather than due to diabetes per se.
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Vrtovec et al. (2005) conducted a case-control in Type 2 Diabetes and Coronary Artery Disease (n=76). Coronary artery disease vs. Absence of coronary artery disease was evaluated on Increased ventricular repolarization dynamics (SDNN(QT) >12 ms or rMSSD(QT) >16 ms) (HR 4.4, 95% CI 1.4-13.7, p=0.008). The presence of coronary artery disease in patients with type 2 diabetes was an independent predictor of increased ventricular repolarization dynamics (HR 4.4).
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