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Prevalence and risk factors of prolonged QT interval and electrocardiographic abnormalities in persons living with HIV

Knudsen, AD; Kofoed, KF; Gelpi, M; Sigvardsen, PE; Mocroft, A; Kühl, JT; Fuchs, A; ... Copenhagen Comorbidity in HIV Infection (COCOMO) Study, ; + view all (2019) Prevalence and risk factors of prolonged QT interval and electrocardiographic abnormalities in persons living with HIV. AIDS , 15 (33) pp. 2205-2210. 10.1097/QAD.0000000000002327. Green open access

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Abstract

OBJECTIVE: Abnormal electrocardiograms (ECG) are associated with increased risk of arrhythmias and sudden cardiac death. We aimed to investigate the prevalence and associated risk factors of prolonged QTc and major ECG abnormalities, in persons living with HIV (PLWH) and uninfected controls. DESIGN: PLWH aged ≥40 were recruited from the Copenhagen comorbidity in HIV infection (COCOMO) study and matched on sex and age to uninfected controls from the Copenhagen General Population Study. METHODS: ECGs were categorized according to Minnesota Code Manual of ECG Findings definition of major abnormalities. A QT interval corrected for heart rate (QTc) >440ms in males and >460ms in females was considered prolonged. Pathologic Q-waves were defined as presence of major Q-wave abnormalities. RESULTS: ECGs were available for 745 PLWH and 2,977 controls. Prolonged QTc was prevalent in 9% of PLWH and 6% of controls, p = .052. Pathologic Q-waves were more common in PLWH (6%) than in controls (4%), p = .028. There was no difference in prevalence of major ECG abnormalities between PLWH and controls, p = .987.In adjusted analyses, HIV was associated with a 3.6ms[1.8-5.4] longer QTc interval, p < .001, and HIV was independently associated with prolonged QTc (adjusted odds ratio: 1.59 [1.14-2.19]), p = .005. HIV was borderline associated to pathologic Q-waves after adjusting, p = .051. CONCLUSION: HIV was associated with higher odds ratio of prolonged QTc after adjustment for cardiovascular risk factors, but analyses were not adjusted for QT-prolonging medication. Although evidence indicated more pathologic Q-waves in PLWH, the risk seemed to be associated mainly with an adverse risk profile.

Type: Article
Title: Prevalence and risk factors of prolonged QT interval and electrocardiographic abnormalities in persons living with HIV
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAD.0000000000002327
Publisher version: https://doi.org/10.1097/QAD.0000000000002327
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: HIV; ECG; EKG; QT interval; Abnormalities; Cardiovascular disease; Comorbidities
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10079682
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