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Prevalence and predictors of long corrected QT interval in HIV-positive patients: a multicenter study.

Prevalence and predictors of long corrected QT interval in HIV-positive patients: a multicenter study.
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Gili S, Mancone M, Ballocca F, Grosso Marra W, Calcagno A, D'Ettorre G, Cannillo M, D'Ascenzo F, Orofino G, Marruncheddu L, Lonni E, Cinque A, Vullo F, Ceccarelli G, Vilardi I, Sardella G, Vullo V, Moretti C, Fedele F, Bonora S, Gaita F,


Gili S, Mancone M, Ballocca F, Grosso Marra W, Calcagno A, D'Ettorre G, Cannillo M, D'Ascenzo F, Orofino G, Marruncheddu L, Lonni E, Cinque A, Vullo F, Ceccarelli G, Vilardi I, Sardella G, Vullo V, Moretti C, Fedele F, Bonora S, Gaita F, (click to view)

Gili S, Mancone M, Ballocca F, Grosso Marra W, Calcagno A, D'Ettorre G, Cannillo M, D'Ascenzo F, Orofino G, Marruncheddu L, Lonni E, Cinque A, Vullo F, Ceccarelli G, Vilardi I, Sardella G, Vullo V, Moretti C, Fedele F, Bonora S, Gaita F,

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Journal of cardiovascular medicine (Hagerstown, Md.) 2016 9 15()

Abstract
AIMS
HIV and highly active antiretroviral therapy (HAART) may affect cardiac conduction, and a higher incidence of sudden death has been recognized in HIV-positive patients. Nevertheless, predictors of prolonged corrected QT interval (cQT) have been poorly described. The aim of the study was to investigate the prevalence and predictors of long cQT in a cohort of HIV-positive patients.

METHODS
Consecutive HIV-positive patients followed in a primary prevention clinic at two Italian institutions were retrospectively enrolled. A 12-lead ECG was recorded in all patients; main clinical features were collected. Prevalence of long cQT (defined as cQT >470 ms in women and >450 ms in men) was the primary end-point. Secondary end-points were the identification of predictors of cQT prolongation, and the association between HAART and HIV-related features with long cQT.

RESULTS
Three hundred and fifty-one HIV-positive patients were included, 26 (7.4%) with long cQT. Mean age was higher among those with long cQT (51.6 vs. 57.6 years; P = 0.007). A higher prevalence of long cQT was reported for patients with a CD4+ cell count below 200 cells/μl at the moment of ECG (60 vs. 24.2%; P = 0.002) and with a nadir of CD4+ cell count below 200 cells/μl (91.3 vs. 58.6%; P = 0.001). At multivariate analysis, only the nadir of CD4+ cell count below 200 cells/μl consistently related to the presence of long cQT (odds ratio 5.8, 95% confidence interval 1.3-26.4).

CONCLUSION
A low CD4+ cell count is associated with long cQT independently from HAART in HIV-positive patients and may be useful to correctly stratify arrhythmic risk in these patients.

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