Skip to main content

ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1418428

Coronary Artery Disease and the Risk of Life-Threatening Cardiac Events after Age 40 in Long QT Syndrome

Provisionally accepted
Alon Barsheshet Alon Barsheshet 1,2*Ilan Goldenberg Ilan Goldenberg 3Milica Bjelic Milica Bjelic 3Kirill Buturlin Kirill Buturlin 1,2Aharon Erez Aharon Erez 1,2Gustavo Goldenberg Gustavo Goldenberg 1,2Anita Y. Chen Anita Y. Chen 3Bronislava Polonsky Bronislava Polonsky 3Scott Mcnitt Scott Mcnitt 3Mehmet Aktas Mehmet Aktas 3Wojciech Zareba Wojciech Zareba 3Gregory Golovchiner Gregory Golovchiner 1,2
  • 1 Tel Aviv University, Tel Aviv, Israel
  • 2 Department of Cardiology, Rabin Medical Center, Petah-Tikva, Israel
  • 3 Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, NY, United States

The final, formatted version of the article will be published soon.

    Background and aims: Long QT syndrome (LQTS) and coronary artery disease (CAD) are both associated with increased risk of ventricular tachyarrhythmia. However, there are limited data on the incremental risk conferred by CAD in adult patients with congenital LQTS. We aimed to investigate the risk associated with CAD and life threatening events (LTEs) in patients with LQTS after age 40 years. Methods: The risk of LTEs (comprising aborted cardiac arrest, sudden cardiac death, or appropriate defibrillator shock) from age 40 through 75 years was examined in 1020 subjects from the Rochester LQTS registry, categorized to CAD (n=137) or no-CAD (n=883) subgroups. Results: Survival analysis showed that patients with CAD had a significantly higher cumulative event rate of LTEs from 40 through 75 years (35%) compared with those without CAD (7%; p<0.001 for the overall difference during follow-up). Consistently, multivariate analysis showed that the presence of CAD was associated with a 2.5-fold (HR=2.47; p=0.02) increased risk of LTEs after age 40 years. Subgroup analyses showed that CAD vs. no CAD was associated with a pronounced >4-fold (p=0.008) increased risk of LTEs among LQTS patients with a lower-range QTc (<500 msec). The increased risk of LTEs associated with CAD was not significantly different among the 3 main LQTS genotypes. Patient treatment was suboptimal, with only 63% on β-blockers and 44% on non-selective β-blockers. Conclusions: Our findings suggest that CAD is associated with a higher risk of LTEs in LQTS patients, with the risk being more pronounced in those with QTc <500 msec.

    Keywords: Long QT Syndrome, Coronary Artery Disease, Sudden cardiac death, ventricular arrhythmia, Risk factors

    Received: 16 Apr 2024; Accepted: 07 Oct 2024.

    Copyright: © 2024 Barsheshet, Goldenberg, Bjelic, Buturlin, Erez, Goldenberg, Chen, Polonsky, Mcnitt, Aktas, Zareba and Golovchiner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Alon Barsheshet, Tel Aviv University, Tel Aviv, Israel

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.