TY - JOUR
T1 - Prolongation of the heart rate-corrected QT interval is associated with cardiovascular diseases
T2 - Systematic review and meta-analysis
AU - Welten, Sabrina J. G. C.
AU - Elders, Petra J. M.
AU - Remmelzwaal, Sharon
AU - Doekhie, Roos
AU - ESCAPE-NET Investigators
AU - Kee, Kok Wai
AU - Nijpels, Giel
AU - van der Heijden, Amber A.
N1 - Funding Information: This work was supported by the European Union's Horizon 2020 research and innovation programme ESCAPE-NET [grant number 733381 ]. Publisher Copyright: © 2023 The Authors
PY - 2023/2
Y1 - 2023/2
N2 - Background: Conflicting findings have described the association between prolonged heart rate-corrected QT interval (QTc) and cardiovascular disease. Aims: To identify articles investigating the association between QTc and cardiovascular disease morbidity and mortality, and to summarize the available evidence for the general and type 2 diabetes populations. Methods: A systematic search was performed in PubMed and Embase in May 2022 to identify studies that investigated the association between QTc prolongation and cardiovascular disease in both the general and type 2 diabetes populations. Screening, full-text assessment, data extraction and risk of bias assessment were performed independently by two reviewers. Effect estimates were pooled across studies using random-effect models. Results: Of the 59 studies included, 36 qualified for meta-analysis. Meta-analysis of the general population studies showed a significant association for: overall cardiovascular disease (fatal and non-fatal) (hazard ratio [HR] 1.68, 95% confidence interval [CI] 1.33–2.12; I2 = 69%); coronary heart disease (fatal and non-fatal) in women (HR 1.27, 95% CI 1.08–1.50; I2 = 38%; coronary heart disease (fatal and non-fatal) in men (HR 2.07, 95% CI 1.26–3.39; I2 = 78%); stroke (HR 1.59, 95% CI 1.29–1.96; I2 = 45%); sudden cardiac death (HR 1.60, 95% CI 1.14–2.25; I2 = 68%); and atrial fibrillation (HR 1.55, 95% CI 1.31–1.83; I2 = 0.0%). No significant association was found for cardiovascular disease in the type 2 diabetes population. Conclusion: QTc prolongation was associated with risk of cardiovascular disease in the general population, but not in the type 2 diabetes population.
AB - Background: Conflicting findings have described the association between prolonged heart rate-corrected QT interval (QTc) and cardiovascular disease. Aims: To identify articles investigating the association between QTc and cardiovascular disease morbidity and mortality, and to summarize the available evidence for the general and type 2 diabetes populations. Methods: A systematic search was performed in PubMed and Embase in May 2022 to identify studies that investigated the association between QTc prolongation and cardiovascular disease in both the general and type 2 diabetes populations. Screening, full-text assessment, data extraction and risk of bias assessment were performed independently by two reviewers. Effect estimates were pooled across studies using random-effect models. Results: Of the 59 studies included, 36 qualified for meta-analysis. Meta-analysis of the general population studies showed a significant association for: overall cardiovascular disease (fatal and non-fatal) (hazard ratio [HR] 1.68, 95% confidence interval [CI] 1.33–2.12; I2 = 69%); coronary heart disease (fatal and non-fatal) in women (HR 1.27, 95% CI 1.08–1.50; I2 = 38%; coronary heart disease (fatal and non-fatal) in men (HR 2.07, 95% CI 1.26–3.39; I2 = 78%); stroke (HR 1.59, 95% CI 1.29–1.96; I2 = 45%); sudden cardiac death (HR 1.60, 95% CI 1.14–2.25; I2 = 68%); and atrial fibrillation (HR 1.55, 95% CI 1.31–1.83; I2 = 0.0%). No significant association was found for cardiovascular disease in the type 2 diabetes population. Conclusion: QTc prolongation was associated with risk of cardiovascular disease in the general population, but not in the type 2 diabetes population.
KW - Cardiovascular diseases
KW - ESCAPE-NET
KW - QT interval
KW - QTc prolongation
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85147554437&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.acvd.2022.11.007
DO - https://doi.org/10.1016/j.acvd.2022.11.007
M3 - Article
C2 - 36690508
SN - 1875-2136
VL - 116
SP - 69
EP - 78
JO - Archives of cardiovascular diseases
JF - Archives of cardiovascular diseases
IS - 2
ER -