Unit of Epidemiology, Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, People's Republic of China.
State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, People's Republic of China.
Clin Interv Aging. 2018 Apr 27;13:797-804. doi: 10.2147/CIA.S149791. eCollection 2018.
Risk factors for heart rate-corrected QT interval (QTc) proglongation should be explored to stratify high-risk individuals to aid the prevention of incident cardiovascular events and mortality. The diversity of risk factors for QTc prolongation suggests that use of the frailty index (FI), indicating general health deficits, may be an effective approach, especially in the elderly, to identify the risk of QTc prolongation.
We used the data of 1,780 individuals aged 70-87 years from the Rugao Longevity and Ageing Study (RuLAS), a community-based longitudinal study. The FI was constructed using 20 routine laboratory tests, plus the body mass index and measures of systolic and diastolic blood pressures (FI-Lab).
The mean FI-Lab value was 0.24±0.09. The mean heart rate-corrected QT interval (QTc) was 407±38 ms. The prevalence of QTc prolongation was 5.2% in elderly community populations aged 70-87 years. A higher FI-Lab value was associated with a higher risk for QTc prolongation. Each 10% increase in the FI-Lab value increased the odds ratio (OR) by 33% (OR: 1.33; 95% CI: 1.07-1.64). Compared with the lowest quartile, the top quartile FI-Lab score was associated with a 2.50-fold QTc prolongation risk in elderly individuals (95% CI: 1.21-5.19).
An FI based on routine laboratory data can identify older adults at increased risk for QTc prolongation. The FI approach may therefore be useful for the risk stratification of QTc prolongation.
应当探索导致心率校正 QT 间期(QTc)延长的风险因素,以对高危个体进行分层,帮助预防心血管事件和死亡的发生。导致 QTc 延长的风险因素多种多样,这表明使用表示一般健康缺陷的衰弱指数(FI)可能是一种有效的方法,尤其是在老年人中,以确定 QTc 延长的风险。
我们使用了来自基于社区的纵向研究——如皋长寿与衰老研究(RuLAS)的 1780 名年龄在 70-87 岁的个体的数据。使用 20 项常规实验室检查、体重指数和收缩压及舒张压测量值构建 FI(FI-Lab)。
FI-Lab 值的平均值为 0.24±0.09。校正后的 QT 间期(QTc)的平均值为 407±38ms。70-87 岁的老年社区人群中,QTc 延长的患病率为 5.2%。FI-Lab 值越高,QTc 延长的风险越高。FI-Lab 值每增加 10%,比值比(OR)增加 33%(OR:1.33;95%CI:1.07-1.64)。与最低四分位数相比,FI-Lab 值最高四分位数与老年人 QTc 延长风险增加 2.50 倍相关(95%CI:1.21-5.19)。
基于常规实验室数据的 FI 可识别出 QTc 延长风险增加的老年人。因此,FI 方法可能有助于 QTc 延长的风险分层。