Abstract 19035: Cardiovascular QTc Interval-Prolonging Medications and the Risk of Death, Stroke and Incident Atrial Fibrillation in the Atherosclerosis Risk in Communities (ARIC) Study
Objective: Prolongation of corrected QT interval (QTc) has been linked with increased risk of stroke, atrial fibrillation (AF) and mortality. We examined the associations between cardiovascular QTc prolonging medications (QTPMs) and these outcomes in a longitudinal study of a population-based cohort.
Methods: We assessed 7,183 ARIC participants with a resting, standard 12-lead electrocardiogram and ≥ 1 measure of cardiovascular medication over up to four triennial examinations between 1987 and 1998. Participants with QRS ≥ 120 ms, atrial fibrillation and stroke were excluded. We identified participants using QTPMs classified as known, possible or conditional by CredibleMed®. Participants were followed on average for 3.2 visits, resulting in 18,287 person-visit observations for all users and 5, 178 for new users, no prior exposure). In all users and new users, we used generalized estimating equation logistic regression with inverse propensity score weighting to examine the association between cardiovascular QTPMs, in comparison to cardiovascular non-QTPMs, and the composite end point of death, stroke or incident AF within 3 years of each visit. The regressions controlled for person characteristics and whether QTPM were for cardiovascular conditions.
Results: The participants’ mean age was 60 +4 years; 70% were females. The composite outcome occurred in 956 visits (5.2%) during the 3-year follow-up periods. Known cardiovascular QTPMs increased the risk of composite outcome threefold, due to significant increase for all components of the endpoint. In contrast, conditional cardiovascular QTPMs were associated with reduction in the composite end point.(Table). No participants were taking Possible QTPMs.
Conclusions: Known cardiovascular QTPMs were associated with an increased risk of composite outcome of death, stroke and incident atrial fibrillation compared to cardiovascular non-QTPMs.
Author Disclosures: K.A. Alburikan: None. S.T. Savitz: None. J.E. Tisdale: None. E.Z. Soliman: None. C.A. Sueta: None. S.C. Stearns: None. J.E. Rodgers: None.
- © 2015 by American Heart Association, Inc.