Correlation between QTc interval prolongation on the electrocardiogram and carotid atherosclerosis in elderly patients with type 2 diabetes mellitus / 中华老年医学杂志

ABSTRACT

Objective:To investigate the correlation between the prolongation of the QTc interval and carotid atherosclerosis in elderly patients with type 2 diabetes mellitus(T2DM).Methods:CIinical data of 212 elderly patients with T2DM admitted to our hospital from February 2016 to February 2019 were retrospectively collected.Based on carotid intima-media thickness(CIMT), patients were divided into the CIMT≥1.0 mm group(n=110)and the CIMT<1.0 mm group (n=102). Meanwhile, patients were divided into the prolonged QTc interval group(QTc interval>440 ms, n=50)and the normal QTc interval group(QTc interval≤440 ms, n=162), base on the adjusted QTc interval.General clinical data were compared between the groups, and the logistic regression equation was used to analyze the related factors for carotid atherosclerosis.Results:Higher values of age, duration of disease, systolic blood pressure(SBP), fasting plasma glucose(FPG), triglycerides(TG), creatinine(Cr), uric acid and C-reactive protein(CRP)were found in the CIMT≥1.0 mm group than in the CIMT<1.0 mm group( P<0.05). The QTc interval was longer in the CIMT≥1.0 mm group than in the CIMT<1.0 mm group[(419.2 ± 42.6) ms vs. (396.5 ± 45.2) ms, t=3.849, P<0.01]. CIMT was greater in the prolonged QTc interval group than in the normal QTc interval group[(1.2± 0.3)mm vs.(0.9±0.3) mm, t=6.956, P<0.01]. The detection rates of carotid atherosclerosis, intimal thickening and atheromatous plaques were higher in the prolonged QTc interval group than in the normal QTc interval group( 76.0% or 38 vs. 44.4% or 72, 32.0% or 16 vs.18.5% or 30 and 44.0% or 22 vs.25.9% or 42, respectively, χ2=15.239, 4.087 and 5.922, P<0.05). Pearson’s correlation analysis showed that CIMI was positively correlated with age, duration of disease, SBP, FPG, TG, Cr, uric acid, CRP and QTc interval( P<0.05). Multivariate logistic regression showed that the risk of carotid atherosclerosis in patients with QTc interval>440 ms was 1.761 times higher than that in patients with QTc≤440 ms( OR=1.761, 95% CI 1.460-3.126, P<0.01). Conclusions:QTc interval prolongation is correlated with carotid atherosclerosis in elderly patients with T2DM, and attention should be paid to the QTc interval on the electrocardiogram, which is helpful to assess the risk of carotid atherosclerosis in elderly T2DM patients.