Race and gender variation in the QT interval and its association with mortality in patients with coronary artery disease: Results from the Duke Databank for Cardiovascular Disease (DDCD)
Background In several studies, prolongation of the corrected QT (QTc) interval has been associated with an increased risk of cardiac events. However, data on race and gender variation in the QTc and its associated risk of death are lacking. Methods We prospectively followed 19,252 subjects who under...
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| Veröffentlicht in: | The American heart journal 2012-09, Vol.164 (3), p.434-441 |
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| creator | Williams, Eric S., MD Thomas, Kevin L., MD Broderick, Samuel, MS Shaw, Linda K., MS Velazquez, Eric J., MD Al-Khatib, Sana M., MD, MHS Daubert, James P., MD |
| description | Background In several studies, prolongation of the corrected QT (QTc) interval has been associated with an increased risk of cardiac events. However, data on race and gender variation in the QTc and its associated risk of death are lacking. Methods We prospectively followed 19,252 subjects who underwent cardiac catheterization and had at least 1 native coronary artery stenosis ≥ 75%. Automated QTc measurements were obtained from a baseline electrocardiogram. Results The mean age of the population was 62.4 years, with 35% being female and 20% being black. The QTc varied by gender and race (417.9 ± 34.4 ms in men and 433.4 ± 33.6 ms in women, 422.1 ± 34.3 ms in whites and 428.1 ± 36.9 ms in blacks; P < .0001 for both). Risk factors most strongly associated with a prolonged QTc were lower ejection fraction, higher diastolic blood pressure, history of myocardial infarction, and lower glomerular filtration rate. Black race and female gender were also independently associated with a prolonged QTc, after adjustment for cardiac risk factors. Moreover, there was an independent association between QTc and all-cause mortality (hazard ratio 1.037 per 10-ms increase, P < .0001). The increased mortality risk associated with a 10-ms increase in the QTc interval was significantly greater for men compared with women (4.6% vs 2.4%, P = .004) and slightly greater for blacks compared with other races (5.0% vs 3.3%, P = .057). Conclusions Among patients with coronary artery disease, QTc prolongation is independently associated with all-cause mortality. The increased mortality risk is higher for men than for women, with a trend toward higher mortality in blacks. |
| doi_str_mv | 10.1016/j.ahj.2012.05.024 |
| format | Article |
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However, data on race and gender variation in the QTc and its associated risk of death are lacking. Methods We prospectively followed 19,252 subjects who underwent cardiac catheterization and had at least 1 native coronary artery stenosis ≥ 75%. Automated QTc measurements were obtained from a baseline electrocardiogram. Results The mean age of the population was 62.4 years, with 35% being female and 20% being black. The QTc varied by gender and race (417.9 ± 34.4 ms in men and 433.4 ± 33.6 ms in women, 422.1 ± 34.3 ms in whites and 428.1 ± 36.9 ms in blacks; P < .0001 for both). Risk factors most strongly associated with a prolonged QTc were lower ejection fraction, higher diastolic blood pressure, history of myocardial infarction, and lower glomerular filtration rate. Black race and female gender were also independently associated with a prolonged QTc, after adjustment for cardiac risk factors. Moreover, there was an independent association between QTc and all-cause mortality (hazard ratio 1.037 per 10-ms increase, P < .0001). The increased mortality risk associated with a 10-ms increase in the QTc interval was significantly greater for men compared with women (4.6% vs 2.4%, P = .004) and slightly greater for blacks compared with other races (5.0% vs 3.3%, P = .057). Conclusions Among patients with coronary artery disease, QTc prolongation is independently associated with all-cause mortality. The increased mortality risk is higher for men than for women, with a trend toward higher mortality in blacks.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2012.05.024</identifier><identifier>PMID: 22980312</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>African Continental Ancestry Group ; Aged ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiac Catheterization ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Cohort Studies ; Continental Population Groups ; Coronary Artery Disease - ethnology ; Coronary Artery Disease - mortality ; Coronary heart disease ; Databases, Factual ; Drug therapy ; Electrocardiography ; Female ; Heart ; Heart attacks ; Humans ; Kaplan-Meier Estimate ; Long QT Syndrome - ethnology ; Long QT Syndrome - mortality ; Male ; Medical sciences ; Middle Aged ; Mortality ; Prevalence ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Sex Factors</subject><ispartof>The American heart journal, 2012-09, Vol.164 (3), p.434-441</ispartof><rights>Mosby, Inc.</rights><rights>2012 Mosby, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Mosby, Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Sep 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-1d690a255cdce7a6241a155250ebc862e5613d13a90d0b4c97d1dbc7ac7eb9453</citedby><cites>FETCH-LOGICAL-c466t-1d690a255cdce7a6241a155250ebc862e5613d13a90d0b4c97d1dbc7ac7eb9453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1644835395?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26399845$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22980312$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Williams, Eric S., MD</creatorcontrib><creatorcontrib>Thomas, Kevin L., MD</creatorcontrib><creatorcontrib>Broderick, Samuel, MS</creatorcontrib><creatorcontrib>Shaw, Linda K., MS</creatorcontrib><creatorcontrib>Velazquez, Eric J., MD</creatorcontrib><creatorcontrib>Al-Khatib, Sana M., MD, MHS</creatorcontrib><creatorcontrib>Daubert, James P., MD</creatorcontrib><title>Race and gender variation in the QT interval and its association with mortality in patients with coronary artery disease: Results from the Duke Databank for Cardiovascular Disease (DDCD)</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background In several studies, prolongation of the corrected QT (QTc) interval has been associated with an increased risk of cardiac events. However, data on race and gender variation in the QTc and its associated risk of death are lacking. Methods We prospectively followed 19,252 subjects who underwent cardiac catheterization and had at least 1 native coronary artery stenosis ≥ 75%. Automated QTc measurements were obtained from a baseline electrocardiogram. Results The mean age of the population was 62.4 years, with 35% being female and 20% being black. The QTc varied by gender and race (417.9 ± 34.4 ms in men and 433.4 ± 33.6 ms in women, 422.1 ± 34.3 ms in whites and 428.1 ± 36.9 ms in blacks; P < .0001 for both). Risk factors most strongly associated with a prolonged QTc were lower ejection fraction, higher diastolic blood pressure, history of myocardial infarction, and lower glomerular filtration rate. Black race and female gender were also independently associated with a prolonged QTc, after adjustment for cardiac risk factors. Moreover, there was an independent association between QTc and all-cause mortality (hazard ratio 1.037 per 10-ms increase, P < .0001). The increased mortality risk associated with a 10-ms increase in the QTc interval was significantly greater for men compared with women (4.6% vs 2.4%, P = .004) and slightly greater for blacks compared with other races (5.0% vs 3.3%, P = .057). Conclusions Among patients with coronary artery disease, QTc prolongation is independently associated with all-cause mortality. The increased mortality risk is higher for men than for women, with a trend toward higher mortality in blacks.</description><subject>African Continental Ancestry Group</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac Catheterization</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cohort Studies</subject><subject>Continental Population Groups</subject><subject>Coronary Artery Disease - ethnology</subject><subject>Coronary Artery Disease - mortality</subject><subject>Coronary heart disease</subject><subject>Databases, Factual</subject><subject>Drug therapy</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Long QT Syndrome - ethnology</subject><subject>Long QT Syndrome - mortality</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Prevalence</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kl2LEzEUhgdR3HX1B3gjARHWi9Ykk8nMKAjS-gUL4rpehzPJqU07TWqSqfSv-evMtNWFvfAmH-R535OcN0XxlNEpo0y-Wk1huZpyyviUVlPKxb3inNG2nshaiPvFOaWUT5qalmfFoxhXeSt5Ix8WZ5y3DS0ZPy9-X4NGAs6QH-gMBrKDYCFZ74h1JC2RfL3Jq4RhB_2BsykSiNHrE_bLpiXZ-JCgt2k_qrb5AF3GDkfaB-8g7AmE7LInxkaEiK_JNcahz9Qi-M2h0nxY5wESdODWZOEDmUEw1u8g6qGHQOZHKbmcz2fzl4-LBwvoIz45zRfF9w_vb2afJldfPn6evbuaaCFlmjAjWwq8qrTRWIPkggGrKl5R7HQjOVaSlYaV0FJDO6Hb2jDT6Rp0jV0rqvKiuDz6boP_OWBMamOjxr4Hh36IilHBaM6gZRl9fgdd-SG4fDvFpBBNWZXtaMiOlA4-xoALtQ12k1uUrdQYrFqpHKwag1W0UjnYrHl2ch66DZp_ir9JZuDFCcjdgn4RwGkbbzlZtm1zeM2bI4e5ZTuLQUWd09JobECdlPH2v9d4e0ete-tsLrjGPcbb16qYNerb-APHD8g4pWXTivIPf-jWpw</recordid><startdate>20120901</startdate><enddate>20120901</enddate><creator>Williams, Eric S., MD</creator><creator>Thomas, Kevin L., MD</creator><creator>Broderick, Samuel, MS</creator><creator>Shaw, Linda K., MS</creator><creator>Velazquez, Eric J., MD</creator><creator>Al-Khatib, Sana M., MD, MHS</creator><creator>Daubert, James P., MD</creator><general>Mosby, Inc</general><general>Mosby</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120901</creationdate><title>Race and gender variation in the QT interval and its association with mortality in patients with coronary artery disease: Results from the Duke Databank for Cardiovascular Disease (DDCD)</title><author>Williams, Eric S., MD ; Thomas, Kevin L., MD ; Broderick, Samuel, MS ; Shaw, Linda K., MS ; Velazquez, Eric J., MD ; Al-Khatib, Sana M., MD, MHS ; Daubert, James P., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-1d690a255cdce7a6241a155250ebc862e5613d13a90d0b4c97d1dbc7ac7eb9453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>African Continental Ancestry Group</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac Catheterization</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Cohort Studies</topic><topic>Continental Population Groups</topic><topic>Coronary Artery Disease - ethnology</topic><topic>Coronary Artery Disease - mortality</topic><topic>Coronary heart disease</topic><topic>Databases, Factual</topic><topic>Drug therapy</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Long QT Syndrome - ethnology</topic><topic>Long QT Syndrome - mortality</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Prevalence</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Williams, Eric S., MD</creatorcontrib><creatorcontrib>Thomas, Kevin L., MD</creatorcontrib><creatorcontrib>Broderick, Samuel, MS</creatorcontrib><creatorcontrib>Shaw, Linda K., MS</creatorcontrib><creatorcontrib>Velazquez, Eric J., MD</creatorcontrib><creatorcontrib>Al-Khatib, Sana M., MD, MHS</creatorcontrib><creatorcontrib>Daubert, James P., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Williams, Eric S., MD</au><au>Thomas, Kevin L., MD</au><au>Broderick, Samuel, MS</au><au>Shaw, Linda K., MS</au><au>Velazquez, Eric J., MD</au><au>Al-Khatib, Sana M., MD, MHS</au><au>Daubert, James P., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Race and gender variation in the QT interval and its association with mortality in patients with coronary artery disease: Results from the Duke Databank for Cardiovascular Disease (DDCD)</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2012-09-01</date><risdate>2012</risdate><volume>164</volume><issue>3</issue><spage>434</spage><epage>441</epage><pages>434-441</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background In several studies, prolongation of the corrected QT (QTc) interval has been associated with an increased risk of cardiac events. However, data on race and gender variation in the QTc and its associated risk of death are lacking. Methods We prospectively followed 19,252 subjects who underwent cardiac catheterization and had at least 1 native coronary artery stenosis ≥ 75%. Automated QTc measurements were obtained from a baseline electrocardiogram. Results The mean age of the population was 62.4 years, with 35% being female and 20% being black. The QTc varied by gender and race (417.9 ± 34.4 ms in men and 433.4 ± 33.6 ms in women, 422.1 ± 34.3 ms in whites and 428.1 ± 36.9 ms in blacks; P < .0001 for both). Risk factors most strongly associated with a prolonged QTc were lower ejection fraction, higher diastolic blood pressure, history of myocardial infarction, and lower glomerular filtration rate. Black race and female gender were also independently associated with a prolonged QTc, after adjustment for cardiac risk factors. Moreover, there was an independent association between QTc and all-cause mortality (hazard ratio 1.037 per 10-ms increase, P < .0001). The increased mortality risk associated with a 10-ms increase in the QTc interval was significantly greater for men compared with women (4.6% vs 2.4%, P = .004) and slightly greater for blacks compared with other races (5.0% vs 3.3%, P = .057). Conclusions Among patients with coronary artery disease, QTc prolongation is independently associated with all-cause mortality. The increased mortality risk is higher for men than for women, with a trend toward higher mortality in blacks.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>22980312</pmid><doi>10.1016/j.ahj.2012.05.024</doi><tpages>8</tpages></addata></record> |
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| subjects | African Continental Ancestry Group Aged Biological and medical sciences Cardiac arrhythmia Cardiac Catheterization Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease Cohort Studies Continental Population Groups Coronary Artery Disease - ethnology Coronary Artery Disease - mortality Coronary heart disease Databases, Factual Drug therapy Electrocardiography Female Heart Heart attacks Humans Kaplan-Meier Estimate Long QT Syndrome - ethnology Long QT Syndrome - mortality Male Medical sciences Middle Aged Mortality Prevalence Proportional Hazards Models Prospective Studies Risk Factors Sex Factors |
| title | Race and gender variation in the QT interval and its association with mortality in patients with coronary artery disease: Results from the Duke Databank for Cardiovascular Disease (DDCD) |
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