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- Title
Association of long QT syndrome loci and cardiac events among patients treated with beta-blockers.
- Authors
Priori SG; Napolitano C; Schwartz PJ; Grillo M; Bloise R; Ronchetti E; Moncalvo C; Tulipani C; Veia A; Bottelli G; Nastoli J; Priori, Silvia G; Napolitano, Carlo; Schwartz, Peter J; Grillo, Massimiliano; Bloise, Raffaella; Ronchetti, Elena; Moncalvo, Cinzia; Tulipani, Chiara; Veia, Alessia
- Abstract
<bold>Context: </bold>Data on the efficacy of beta-blockers in the 3 most common genetic long QT syndrome (LQTS) loci are limited.<bold>Objective: </bold>To describe and assess outcome in a large systematically genotyped population of beta-blocker-treated LQTS patients.<bold>Design, Setting, and Patients: </bold>Consecutive LQTS-genotyped patients (n = 335) in Italy treated with beta-blockers for an average of 5 years.<bold>Main Outcome Measures: </bold>Cardiac events (syncope, ventricular tachycardia/torsades de pointes, cardiac arrest, and sudden cardiac death) while patients received beta-blocker therapy according to genotype.<bold>Results: </bold>Cardiac events among patients receiving beta-blocker therapy occurred in 19 of 187 (10%) LQT1 patients, 27 of 120 (23%) LQT2 patients, and 9 of 28 (32%) LQT3 patients (P<.001). The risk of cardiac events was higher among LQT2 (adjusted relative risk, 2.81; 95% confidence interval [CI], 1.50-5.27; P =.001) and LQT3 (adjusted relative risk, 4.00; 95% CI, 2.45-8.03; P<.001) patients than among LQT1 patients, suggesting inadequate protection from beta-blocker therapy. Other important predictors of risk were a QT interval corrected for heart rate that was more than 500 ms in patients receiving therapy (adjusted relative risk, 2.01; 95% CI, 1.16-3.51; P =.01) and occurrence of a first cardiac event before the age of 7 years (adjusted RR, 4.34; 95% CI, 2.35-8.03; P<.001).<bold>Conclusion: </bold>Among patients with genetic LQTS treated with beta-blockers, there is a high rate of cardiac events, particularly among patients with LQT2 and LQT3 genotypes.
- Publication
JAMA: Journal of the American Medical Association, 2004, Vol 292, Issue 11, p1341
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.292.11.1341