Incidence and Risk Factors of Prolonged QTc Interval in Type 1 Diabetes

Giunti, Sara; Bruno, Graziella; Lillaz, E; Gruden, Gabriella; Lolli, Valentina; Chaturvedi, Nish; Fuller, John; Veglio, M; Cavallo‐Perin, P.

doi:10.2337/dc07-0063

Cited by 46 publications

(38 citation statements)

References 28 publications

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“…In the European Diabetes (EURODIAB) Prospective Complications Study of 1415 people with T1DM, the benefits of mild or vigorous intensity weekly physical activity on preventing the development of a biomarker of cardiovascular disease 269,270 were significant only in men (mild activity: adjusted OR=0.27; 95% CI, 0.10-0.76; vigorous activity: adjusted OR=0.38; 95% CI, 0.14-0.99), not in women (mild activity: adjusted OR=0.74; 95% CI, 0.28-1.96; vigorous activity: adjusted OR=0.54; 95% CI, 0.19-1.49). 271 No test for effect modification by sex was reported. In the Pittsburgh Epidemiology of Diabetes Complications Study of participants with T1DM, the standard cardiovascular risk factors of age, blood pressure, smoking, and ratio of total cholesterol to HDL-C were found to poorly predict rates of incident CHD.…”

Section: Cardiovascular Eventsmentioning

confidence: 99%

Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus

et al. 2015

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Currently, ≈1 in 13 people living in the United States has DM, and 90% to 95% of these individuals have type 2 DM (T2DM).2 Overall, the prevalence of T2DM is similar in women and men. In the United States, ≈12.6 million women (10.8%) and 13 million men (11.8%) ≥20 years of age are currently estimated to have T2DM. 2 Among individuals with T2DM, cardiovascular disease (CVD) is the leading cause of morbidity and mortality and accounts for >75% of hospitalizations and >50% of all deaths.3 Although nondiabetic women have fewer cardiovascular events than nondiabetic men of the same age, this advantage appears to be lost in the context of T2DM. 4,5 The reasons for this advantage are not entirely clear but are likely multifactorial with contributions from inherent physiological differences, including the impact of the sex hormones, differences in cardiovascular risk factors, and differences between the sexes in the diagnosis and treatment of DM and CVD. 6 In addition, there are racial and ethnic factors to consider because women of ethnic minority backgrounds have a higher prevalence of DM than non-Hispanic white (NHW) women.This scientific statement was designed to provide the current state of knowledge about sex differences in the cardiovascular consequences of DM, and it will identify areas that would benefit from further research because much is still unknown about sex differences in DM and CVD. Areas that are discussed include hormonal differences between the sexes and their possible effects on the interaction between DM and CVD, sex differences in epidemiology, ethnic and racial differences and risk factors for CVD in DM across the life span, sex differences in various types of CVD and heart failure, and sex differences in the effects of treatments for DM, including both medications and lifestyle. In addition, there is discussion about risk factors that are specific to women, including gestational diabetes mellitus (GDM) and polycystic ovarian syndrome (PCOS), which affect CVD risk. Table 1 focuses on sex differences in CVD risk factors and outcomes in DM, and Table 2 provides information about sex differences in CVD treatments and interventions in DM. Table 3 contains some of the important ideas for research in sex differences in the cardiovascular consequences of DM. The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on July 31, 2015, and the American Heart Association Executive Committee on September 5, 2015. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By...

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Section: Cardiovascular Eventsmentioning

confidence: 99%

Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus

et al. 2015

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“…2 In the Europe and Diabetes (EURODIAB) study 3 on diabetic individuals with a normal QTc at baseline, female sex and higher values of hemoglobin A 1C and systolic blood pressure were associated with increased risk of prolonged QTc, whereas physical activity and normal body mass index were protective factors. Correlation was found between the QT duration and the amount of coronary calcium; this association was driven by the QRS and not by JT interval duration.…”

Section: Ecg Signs In Diabetic Patientsmentioning

confidence: 99%

The ECG in Diabetes Mellitus

Stern

2009

Circulation

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“…Ventricular instability derived from delayed myocardial repolarization is considered to be associated with a high risk of cardiac sudden death [1,2]. Recently, several studies have examined the correlation between QT abnormalities and diabetes [3]. An increased QTd was reported to predict cardiac death with 100 % sensitivity and 90 % specificity in patients with more than 6 years of diabetes [4].…”

Section: Introductionmentioning

confidence: 99%

Increased serum gamma-glutamyltransferase levels are associated with ventricular instability in type 2 diabetes

Wang

et al. 2015

Endocrine

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The purpose of our study is to examine the association between serum GGT levels and ventricular instability in Chinese patients with T2DM. We conducted a cross-sectional, community-based study in Nanjing, China from June to November 2011. Among 10,050 patients aged 40-79 years, we enrolled 2444 with pre-diabetes, 2496 with T2DM, and 4521 without diabetes (non-diabetes). Electrocardiograms were performed to measure the QT interval corrected for heart rate (QTc) and QT interval dispersion (QTd). Serum GGT levels, metabolic parameters, body mass index, and blood pressure were also measured. We found that there were no significant associations of increased QTc/QTd with serum GGT levels in participants with pre-existing T2DM and non-diabetes, after adjusting for age, duration of diabetes, and metabolic parameters. Even after adjustment, higher risks of QTc ≥ 440 ms/√s and QTd ≥ 58 ms were found in participants with serum GGT levels ≥49 U/L compared with those with <15 U/L in the pre-diabetes (QTc: OR 1.96, 95 % CI 1.23-2.47; QTd: OR 1.34, 95 % CI 1.07-1.94) and newly diagnosed T2DM (QTc: OR 2.01, 95 % CI 1.39-2.51; QTd: OR 1.53, 95 % CI 1.03-1.99) groups. We conclude that Increased serum GGT levels are associated with some markers of ventricular repolarization abnormalities in the early stage of T2DM.

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Incidence and Risk Factors of Prolonged QTc Interval in Type 1 Diabetes

Cited by 46 publications

References 28 publications

Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus

Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus

The ECG in Diabetes Mellitus

Increased serum gamma-glutamyltransferase levels are associated with ventricular instability in type 2 diabetes

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