Effect of Intensive Glycemic and Blood Pressure Control on QT Prolongation in Diabetes: The ACCORD Trial

被引：3

作者：

Singleton, Matthew J. ^{[1
]}

Soliman, Elsayed Z. ^{[1
,2
]}

Bertoni, Alain G. ^{[3
]}

Whalen, S. Patrick ^{[1
]}

Bhave, Prashant D. ^{[1
]}

Yeboah, Joseph ^{[1
]}

机构：

[1] Wake Forest Sch Med, Cardiol Sect, Dept Internal Med, Winston Salem, NC 27101 USA

[2] Wake Forest Sch Med, Epidemiol Cardiol Res Ctr, Winston Salem, NC 27101 USA

[3] Wake Forest Sch Med, Dept Epidemiol & Prevent, Winston Salem, NC 27101 USA

来源：

DIABETES | 2020年 / 69卷 / 10期

关键词：

CONTROL CARDIOVASCULAR RISK; CORONARY-HEART-DISEASE; ATHEROSCLEROSIS RISK; INTERVAL DURATION; MORTALITY; DISPERSION; HYPOGLYCEMIA; ASSOCIATION; ARRHYTHMIAS; VARIABILITY;

D O I：

10.2337/db20-0401

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Compared with standard glycemic control, intensive glycemic control caused increased mortality in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Preliminary data from several studies suggest that intensive glycemic control is associated with QT prolongation, which may lead to ventricular arrhythmias as a possible explanation of this increased mortality. We sought to assess the effects of intensive glycemic control and intensive blood pressure control on the risk of incident QT prolongation. Cox proportional hazards models were used to compare the risk of incident QT prolongation (>460 ms in women or >450 ms in men) in the intensive versus standard glycemic control arms. Over a combined 48,634 person-years of follow-up (mean 4.9), 634 participants (6.4%) developed a prolonged QTc. Participants in the intensive glycemic control arm did not have an increased risk of QT prolongation. Similarly, a strategy of intensive blood pressure control did not result in a significant change in risk of prolonged QTc. Sensitivity analyses using alternative QT correction formulas (Hodges and Bazett) yielded overall similar findings. In conclusion, the increased mortality observed in the intensive glycemic control arm in the ACCORD trial is not likely to be explained by QT prolongation leading to lethal ventricular arrhythmias.

引用

页码：2186 / 2193

页数：8

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