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校正QT间期与中风相关,但与冠心病无关:来自中国普通人群的见解。

Corrected QT Interval Is Associated With Stroke but Not Coronary Heart Disease: Insights From a General Chinese Population.

作者信息

Guo Xiaofan, Li Zhao, Zhou Ying, Yu Shasha, Yang Hongmei, Sun Guozhe, Zheng Liqiang, Lee Byron K, Pletcher Mark J, Sun Yingxian

机构信息

Department of Cardiology, The First Hospital of China Medical University, Shenyang, China.

Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China.

出版信息

Front Cardiovasc Med. 2021 Jul 21;8:605774. doi: 10.3389/fcvm.2021.605774. eCollection 2021.

Abstract

Prolonged heart rate-corrected QT (QTc) interval has been associated with incident cardiovascular diseases (CVD) in general Western populations. However, this association is unclear in Asian population. We aim to estimate the association between QTc interval and incident CVD in a general Chinese population. We analyzed 8,867 participants age ≥35 years and free of CVD at baseline in the Northeast China Rural Cardiovascular Health Study. A resting 12-lead electrocardiogram was performed on all participants, and QTc interval computed using the Framingham formula. Cox proportional hazards models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for associations between QTc interval and incident stroke, coronary heart disease, and combined CVD events. Over a median follow-up of 4.66 years, a total of 439 CVD events occurred (298 stroke cases and 152 CHD cases). After full adjustment, prolonged QTc defined by a sex-specific cutoff was associated with increased risk of developing stroke (HR: 1.82, 95% CI 1.20-2.75, = 0.004) and combined CVD (HR: 1.52, 95% CI 1.05-2.19, = 0.026). Spline analyses demonstrated no clear thresholds; when modeled as a linear relationship, each 10 ms increase of QTc interval was associated with an HR of 1.12 (95% CI 1.06-1.19, < 0.001) for stroke and an HR of 1.10 (95% CI 1.05-1.15, < 0.001) for combined CVD. Baseline QTc interval was not associated with incident CHD with either modeling strategy. Baseline QTc interval is associated with incident stroke and CVD in adults without prior CVD from a general Chinese population.

摘要

在西方普通人群中,心率校正的QT(QTc)间期延长与心血管疾病(CVD)的发生有关。然而,在亚洲人群中这种关联尚不清楚。我们旨在评估中国普通人群中QTc间期与CVD发生之间的关联。我们分析了中国东北农村心血管健康研究中8867名年龄≥35岁且基线时无CVD的参与者。对所有参与者进行静息12导联心电图检查,并使用弗雷明汉公式计算QTc间期。采用Cox比例风险模型计算QTc间期与中风、冠心病及合并CVD事件之间关联的风险比(HRs)及其95%置信区间(CIs)。在中位随访4.66年期间,共发生439例CVD事件(298例中风病例和152例冠心病病例)。在进行全面调整后,由性别特异性临界值定义的QTc间期延长与中风发生风险增加(HR:1.82,95%CI 1.20 - 2.75,P = 0.004)及合并CVD(HR:1.52,95%CI 1.05 - 2.19,P = 0.026)相关。样条分析未显示明确阈值;当建模为线性关系时,QTc间期每增加10 ms,中风的HR为1.12(95%CI 1.06 - 1.19,P < 0.001),合并CVD的HR为1.10(95%CI 1.05 - 1.15,P < 0.001)。两种建模策略下,基线QTc间期均与冠心病发生无关。来自中国普通人群且既往无CVD的成年人中,基线QTc间期与中风及CVD的发生有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/716e/8333696/96841b535ca9/fcvm-08-605774-g0001.jpg

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