Comparison between QT Interval Parameters in Type 2 Diabetic and Nondiabetic Patients with Non-ST Elevation
Hamid Reza Bonakdar1, Masoumeh Aslanpour1, Hassan Moladoust2
1Heshmat Cardiovascular Medical Center, Guilan University of Medical Sciences, Rasht, Iran.
Insights
Patients with type 2 diabetes and non-ST-segment elevation myocardial infarction (NSTEMI) show increased QT interval parameters, suggesting a link to worse cardiac outcomes and prognosis compared to non-diabetic patients.
Area of Science:
- Cardiology
- Diabetology
- Clinical Electrophysiology
Background:
- QT interval parameters are potential predictors of mortality and lethal arrhythmias in myocardial infarction patients.
- Type 2 diabetes mellitus is a significant comorbidity impacting cardiovascular health.
Purpose of the Study:
- To compare QT interval indices in patients with non-ST-segment elevation myocardial infarction (NSTEMI) between type 2 diabetic and non-diabetic individuals.
- To investigate the association of QT parameters with cardiac outcomes in diabetic NSTEMI patients.
Main Methods:
- A case-control study involving 115 NSTEMI patients (47 diabetic, 68 non-diabetic).
- Analysis of maximum (max) and minimum (min) QT interval, corrected QT interval (QTc), QT dispersion (QTd), and corrected QT dispersion (QTcd).
- Assessment of ventricular arrhythmia, coronary angiography, and need for revascularization (CABG/PCI).
Main Results:
- Diabetic NSTEMI patients exhibited significantly higher QTc max, QTd, and QTcd compared to non-diabetic patients.
- Elevated QT parameters were associated with increased need for coronary revascularization and ventricular arrhythmia in diabetic patients.
- QTcd was higher in patients with increased in-hospital mortality, and QTc max, QTd, and QTcd correlated with ventricular arrhythmia in diabetics.
Conclusions:
- Type 2 diabetes is associated with altered QT interval dynamics in NSTEMI.
- Increased QTc max, QTd, and QTcd in diabetic NSTEMI patients may indicate a poorer prognosis and higher risk of adverse cardiac events.
- QT interval indices could serve as valuable biomarkers for risk stratification in diabetic patients post-NSTEMI.
Background:
QT interval parameters have been suggested as a predictor of lethal arrhythmia and mortality in patients with myocardial infarction. The aim of the present study was to compare the value of QT interval indices in patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI) between a group of patients with type 2 diabetes mellitus and a nondiabetic group of patients.
Methods:
This case-control study evaluated QT interval parameters in 115 patients (47 diabetic and 68 nondiabetic patients) diagnosed with NSTEMI between September 2011 and July 2012. The following QT interval indices were analyzed: maximum (max) and minimum (min) QT interval; max and min corrected QT interval (QTc); QT dispersion (QTd); and corrected QT dispersion (QTcd). All the patients were observed for ventricular arrhythmia during their hospital course and underwent coronary angiography. They were selected to undergo coronary artery bypass surgery (CABG) or percutaneous coronary angioplasty (PCI) based on their coronary anatomy.
Results:
The mean age of the patients was 60.8 ± 11.4 years. The patients were 40.0% female and 60.0% male. There were no significant differences in clinical characters between type 2 diabetic and nondiabetic patients with NSTEMI. Compared with post-myocardial infarction patients without diabetes, those with type 2 diabetes had higher QTc max, QTd and QTcd (p value < 0.05). There was a significant difference in QTd and QTcd in the patients needing coronary revascularization with diabetes as opposed to the nondiabetics (p value = 0.035 and p value = 0.025, respectively) as well as those who had ventricular arrhythmia with diabetes (p value = 0.018 and p value = 0.003, respectively). QTcd was higher in the patients who had higher in-hospital mortality (p value = 0.047). The QTc max, QTd and QTcd were significantly (all p values < 0.05) associated with ventricular arrhythmia, QTcd with need for revascularization and QTc max with in-hospital mortality in the diabetic patients.
Conclusion:
Based on the findings of this study, it seems that type 2 diabetics with NSTEMI have greater QTc max, QTd, and QTcd and these QT parameters may have a relationship with worse cardiac outcomes and poorer prognoses.
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