Who is at risk for cardiac events in young patients with long QT syndrome?
The objective of this study was to determine who is at risk for cardiac events among young patients with long QT syndrome (LQTS) with or without a past history of LQTS-related cardiac events. The subjects were young patients with LQTS who had visited one of 36 hospitals from January 1997 to August 2000 in Japan. To predict the risk factors for cardiac events, stepwise regression analyses were performed for a total of 197 cases. There were 7 of 129 cases (5%) without a past history and 32 of the 68 (47%) cases with a past history of LQTS-related cardiac events that experienced new events after diagnosis (p<0.0001). Patients with a family history showed a higher incidence of symptoms both before and after diagnosis than patients with sporadic occurrence. Analyses revealed that noncompliance with medication and a lower age at diagnosis were significant predictors for the group with a past history. A negative predictive value <4 points was 100% in the group without a past history. To prevent future cardiac events, compliance with medication must be improved in those with a past history. A total LQTS score <4 points was useful to predict the absence of cardiac events in the group without a past history.
Yoshinaga
Masao
M
Department of Pediatrics, Faculty of Medicine, Kagoshima University, Kagoshima, Japan. m-yoshi@m2.kufm.kagoshima-u.ac.jp
Nagashima
Masami
M
Shibata
Toshimitsu
T
Niimura
Ichiro
I
Kitada
Mitsuo
M
Yasuda
Toshiaki
T
Iwamoto
Mari
M
Kamimura
Junko
J
Iino
Mayu
M
Horigome
Hitoshi
H
Seguchi
Masashi
M
Aiba
Sumi
S
Izumida
Naomi
N
Kimura
Takashi
T
Ushinohama
Hiroya
H
Nishi
Junichiro
J
Kono
Yukiharu
Y
Nomura
Yuichi
Y
Miyata
Koichiro
K
D000293:Adolescent; D000328:Adult; D002648:Child; D003645:Death, Sudden; D015444:Exercise; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D007564:Japan; D008133:Long QT Syndrome / Q000150:complications* / Q000209:etiology / Q000401:mortality; D008297:Male; D009622:Noise; D012189:Retrospective Studies; D012890:Sleep; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D013550:Swimming; D013997:Time Factors