Determinants of developing widened spatial QRS-T angle in HIV-infected individuals: Results from the Strategies for Management of Antiretroviral Therapy [SMART] Study
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Determinants of developing widened spatial QRS-T angle in HIV-infected individuals : Results from the Strategies for Management of Antiretroviral Therapy [SMART] Study. / Dawood, Farah Z; Roediger, Mollie P; Grandits, Greg; Miller, Dery; Fisher, Martin; Zhang, Zhu-Ming; Hodder, Sally; Hoy, Jennifer F; Lundgren, Jens D; Neaton, James D; Soliman, Elsayed Z; INSIGHT SMART Study Group.
In: Journal of Electrocardiology, Vol. 47, No. 2, 11.01.2014, p. 264-271.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Determinants of developing widened spatial QRS-T angle in HIV-infected individuals
T2 - Results from the Strategies for Management of Antiretroviral Therapy [SMART] Study
AU - Dawood, Farah Z
AU - Roediger, Mollie P
AU - Grandits, Greg
AU - Miller, Dery
AU - Fisher, Martin
AU - Zhang, Zhu-Ming
AU - Hodder, Sally
AU - Hoy, Jennifer F
AU - Lundgren, Jens D
AU - Neaton, James D
AU - Soliman, Elsayed Z
AU - INSIGHT SMART Study Group
N1 - Copyright © 2014 Elsevier Inc. All rights reserved.
PY - 2014/1/11
Y1 - 2014/1/11
N2 - BACKGROUND: A widened electrocardiographic spatial QRS-T angle has been shown to be predictive of cardiovascular disease in HIV-infected individuals. However, determinants and risk factors of developing widened QRS-T angle over time in this population remain unknown.METHODS AND RESULTS: Spatial QRS-T angle was automatically measured from standard electrocardiogram of 1444 HIV-infected individuals without baseline widened spatial QRS-T angle from the Strategies for Management of Antiretroviral Therapy [SMART], a clinical trial comparing two antiretroviral treatment strategies [Drug Conservation (DC) vs. Viral Suppression (VS)]. Conditional logistic regression analysis was used to examine the association between baseline characteristics and incident widened spatial QRS-T angle (a new angle>93° in males and>74° in females). During 2544 person-years of follow-up, 199 participants developed widened angle at a rate of 7.8 per 100 person-years. In unadjusted models, female sex, black race (vs. white), DC treatment strategy, current and past smokers (vs. never), history of alcohol abuse, greater body mass index, history of diabetes and higher levels of hs-C-reactive protein were associated with incident widened spatial QRS-T angle. When these variables were entered together in the same model with adjustment for demographics and treatment strategy, DC treatment strategy [OR (95% CI): 1.50 (1.09, 2.07)], female gender [1.69 (1.17, 2.45)], current and past smoking (vs. never) [2.49 (1.63, 3.81) and 1.93 (1.21, 3.09), respectively], and diabetes [2.28 (1.33, 3.91)] predicted incident widened spatial QRS-T angle.CONCLUSIONS: Drug conservation treatment strategy, female gender, smoking, and diabetes are independently predictive of incident widened spatial QRS-T angle in HIV-infected individuals.
AB - BACKGROUND: A widened electrocardiographic spatial QRS-T angle has been shown to be predictive of cardiovascular disease in HIV-infected individuals. However, determinants and risk factors of developing widened QRS-T angle over time in this population remain unknown.METHODS AND RESULTS: Spatial QRS-T angle was automatically measured from standard electrocardiogram of 1444 HIV-infected individuals without baseline widened spatial QRS-T angle from the Strategies for Management of Antiretroviral Therapy [SMART], a clinical trial comparing two antiretroviral treatment strategies [Drug Conservation (DC) vs. Viral Suppression (VS)]. Conditional logistic regression analysis was used to examine the association between baseline characteristics and incident widened spatial QRS-T angle (a new angle>93° in males and>74° in females). During 2544 person-years of follow-up, 199 participants developed widened angle at a rate of 7.8 per 100 person-years. In unadjusted models, female sex, black race (vs. white), DC treatment strategy, current and past smokers (vs. never), history of alcohol abuse, greater body mass index, history of diabetes and higher levels of hs-C-reactive protein were associated with incident widened spatial QRS-T angle. When these variables were entered together in the same model with adjustment for demographics and treatment strategy, DC treatment strategy [OR (95% CI): 1.50 (1.09, 2.07)], female gender [1.69 (1.17, 2.45)], current and past smoking (vs. never) [2.49 (1.63, 3.81) and 1.93 (1.21, 3.09), respectively], and diabetes [2.28 (1.33, 3.91)] predicted incident widened spatial QRS-T angle.CONCLUSIONS: Drug conservation treatment strategy, female gender, smoking, and diabetes are independently predictive of incident widened spatial QRS-T angle in HIV-infected individuals.
KW - Adult
KW - Anti-HIV Agents
KW - Arrhythmias, Cardiac
KW - C-Reactive Protein
KW - Electrocardiography
KW - Female
KW - HIV Infections
KW - Heart Conduction System
KW - Humans
KW - Male
KW - Risk Factors
KW - Sex Factors
KW - Smoking
U2 - 10.1016/j.jelectrocard.2013.12.001
DO - 10.1016/j.jelectrocard.2013.12.001
M3 - Journal article
C2 - 24406207
VL - 47
SP - 264
EP - 271
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
SN - 0022-0736
IS - 2
ER -
ID: 137313591