Risk factors for prolonged QTc among US adults: Third National Health and Nutrition Examination Survey
Risk factors for prolonged QTc among US adults: Third National Health and Nutrition Examination Survey
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DOI：
10.1097/01.hjr.0000173110.21851.a9
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发表时间：
2005-08-01
影响因子：
--
通讯作者：
Graham, DJ
中科院分区：
文献类型：
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作者：
Benoit, SR;Mendelsohn, AB;Graham, DJ
背景QT间期延长可导致尖端扭转型室性心动过速，这是一种潜在的致命性心律失常。虽然研究存在QT间期延长和临床结果之间的关系，很少有研究描述了QT间期延长的危险因素，在一般population.Methods第三次全国健康与营养检查调查（NHANES 111）收集心电图间期数据8561例40岁以上的受试者和预测结果，美国人口。使用Fridericia公式根据心率校正QT。进行Logistic回归分析，以确定与QTc间期延长独立相关的因素，定义为在人群QTc间期分布的上限5%。由于性别间QT分布的差异以及潜在效应修正，对女性和男性分别进行分析。分析变量包括年龄，种族/民族，电解质测量，体重指数，最近使用的QT延长药物和过去的病史中风，甲状腺疾病，高血压，糖尿病和心肌infarction.Results年龄，女性，低钙血症（男性），低钾血症（女性），甲状腺疾病和心肌梗死（男性）的病史与QTc间期延长。此外，在过去的一个月里，服用QT延长药物与男性和女性的QTc间期延长的几率增加了两倍以上。结论医疗从业人员应该知道，QTc间期延长是心血管风险的潜在指标，并应谨慎在处方潜在QT延长药物给某些患者。
Background QT interval prolongation can lead to torsades de pointes, a potentially fatal arrhythmia. Although research exists on the relationship between QT prolongation and clinical outcome, few studies have described risk factors for prolonged QT interval in the general population.Methods The Third National Health and Nutrition Examination Survey (NHANES 111) collected electrocardiogram interval data on 8561 subjects over 40 years of age and projected results to the US population. QT was corrected for heart rate using Fridericia's formula. Logistic regression analyses were performed to identify factors independently associated with prolonged QTc interval, defined as being in the upper 5% of the population QTc interval distribution. Analyses were conducted separately for women and men as a result of differences in the QT distribution between the sexes and also because of potential effect modification. Analytical variables included age, race/ethnicity, electrolyte measurements, body mass index, the recent use of QT-prolonging drugs and past medical histories of stroke, thyroid disease, hypertension, diabetes and myocardial infarction.Results Age, female sex, hypocalcemia (men), hypokalemia (women), and a history of thyroid disease and myocardial infarction (men) were associated with a prolonged QTc interval. In addition, taking QT-prolonging medications in the past month was associated with more than a twofold increase in the odds of prolonged QTc interval in both men and women.Conclusions Healthcare practitioners should be aware that a prolonged QTc interval is a potential indicator of cardiovascular risk, and should exercise caution in prescribing potentially QT-prolonging medications to certain patients.