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Prolongation of QTc and Risk of Stroke The REGARDS (REasons for Geographic and Racial Differences in Stroke) Study
Journal article   Open access   Peer reviewed

Prolongation of QTc and Risk of Stroke The REGARDS (REasons for Geographic and Racial Differences in Stroke) Study

Elsayed Z. Soliman, George Howard, Mary Cushman, Brett Kissela, Dawn Kleindorfer, Anh Le, Suzanne Judd, Leslie A. McClure and Virginia J. Howard
Journal of the American College of Cardiology, v 59(16), pp 1460-1467
17 Apr 2012
DOI: https://doi.org/10.1016/j.jacc.2012.01.025
PMID: 22497826
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1016/j.jacc.2012.01.025View
Published, Version of Record (VoR)Open Access (Publisher-Specific),  Open

Abstract

Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Science & Technology
Objectives The purpose of this study was to examine the association between prolongation of QT interval corrected for heart rate (QTc) with incident stroke. Background Unlike cardiovascular morbidity and mortality, little is known about the relationship between QTc and risk of stroke. Methods A total of 27,411 participants age 45 years and older without previous stroke from the REGARDS (REasons for Geographic and Racial Differences in Stroke) study were included in this analysis. QTc was calculated using Framingham formula (QTc(Fram)). Stroke cases were identified and adjudicated during up to 8.2 years of follow-up (median, 5.1 years). Results The risk of incident stroke in study participants with prolonged QTc(Fram) was almost 3 times the risk in those with normal QTc(Fram) (hazard ratio [HR] [95% confidence interval (CI)]: 2.88 [2.12 to 3.92], p < 0.0001). After adjustment for demographics (age, race, and sex), traditional stroke risk factors (antihypertensive medication use, systolic blood pressure, current smoking, diabetes, left ventricular hypertrophy, atrial fibrillation, and previous cardiovascular disease), warfarin use, aspirin use, QRS duration and use of QTc-prolonging drugs, the risk of stroke remained significantly high (HR [95% CI]: 1.67 [1.16 to 2.41], p = 0.0061) and was consistent across several subgroups of REGARDS study participants. Similar results were obtained when the risk of stroke was estimated per 1-SD increase in QTc(Fram), (HR [95% CI]: 1.12 [1.03 to 1.21], p = 0.0053 in multivariable-adjusted model) and when other QTc correction formulas including those of Hodge, Bazett, and Fridericia were used. Conclusions QTc prolongation is associated with a significantly increased risk of incident stroke independent of traditional stroke risk factors. Examining the risk of stroke associated with QTc-prolonging drugs may be warranted. (J Am Coll Cardiol 2012;59:1460-7) (C) 2012 by the American College of Cardiology Foundation

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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