Author + information
- Brian Moyers,
- Lauren McGuire,
- Benjamin Colburn,
- Diane Havlir,
- Joseph Wong,
- Priscilla Hsue and
- Zian Tseng
A prolonged QT interval has been variably associated with sudden cardiac death (SCD). HIV-infected individuals have high rates of cardiovascular disease including SCD; the mechanisms likely include traditional risk factors, HIV medications, and inflammation. HIV-infected individuals are frequently prescribed QT prolonging medications, however, the association between QT and SCD in this population has not been evaluated.
We previously characterized all deaths in 2860 consecutive HIV patients from 2000 to 2009 in a public San Francisco clinic. All patients with ≥ 1 ECG during the study period were identified. The effect of Bazett-corrected QT (QTc) on SCD was evaluated with regression and Cox proportional hazard models.
18 SCDs were identified from 657 patients with ≥ 1 ECG. The median time between last ECG and SCD was 284 days. The mean QTc was longer in SCD victims compared to those without (434 vs 414ms, p=0.01). After adjustment for age, gender, race, HTN, DM, and baseline CD4, each 10ms increase in QTc was independently associated with a 13% increased risk of SCD (OR 1.13, 95% CI 1.01-1.26, p=0.027). A QTc >450ms was associated with SCD (OR 3.96, 95% CI 1.36-11.42, p=0.012) as well as all cause mortality (OR 2.19, 95% CI 1.26-3.82, p=0.005) but not AIDS death (p=0.53).
A prolonged QTc predicts SCD but not AIDS death in a large urban HIV cohort. Further work is needed to better define risk markers for SCD and the impact of QT-prolonging medications in this high-risk group.
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias: Utililty of ECG for Patients at Risk of SCD
Abstract Category: 6. Arrhythmias: Other
Presentation Number: 1150M-39
- 2013 American College of Cardiology Foundation