Association between low-level environmental arsenic exposure and QT interval duration in a general population study.
High-level arsenic exposure is consistently associated with QT prolongation, a risk factor for arrhythmia and sudden cardiac death. Arsenic may act on QT by increasing cardiac calcium currents. The authors hypothesized that low-level arsenic exposure would be associated with QT duration and that this effect would be stronger among persons not using calcium channel blockers. They performed a cross-sectional analysis in elderly men from the Normative Aging Study to analyze associations between toenail arsenic and QT and heart rate-corrected QT (QTc) durations and to examine effect modification by calcium channel blocker use, using linear regression and adjusting for potential confounders. Participants were examined in Boston, Massachusetts, between 2000 and 2002 or in 2006. An interquartile range increase in arsenic concentration was associated with a 3.8-millisecond increase in QT (95% confidence interval: 0.82, 6.8) and a 2.5-millisecond increase in QTc (95% confidence interval: 0.11, 4.9). There was no evidence of effect modification by medication use for either QT (P = 0.93) or QTc (P = 0.58). The authors observed positive associations between a biomarker of arsenic exposure and QT duration but found no evidence of effect modification by calcium channel blocker use, possibly because of modest power.
Mordukhovich
Irina
I
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599-7435, USA. irinam@email.unc.edu
Wright
Robert O
RO
Amarasiriwardena
Chitra
C
Baja
Emmanuel
E
Baccarelli
Andrea
A
Suh
Helen
H
Sparrow
David
D
Vokonas
Pantel
P
Schwartz
Joel
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D001151:Arsenic / Q000032:analysis / Q000633:toxicity*; D001152:Arsenicals / Q000009:adverse effects*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D008133:Long QT Syndrome / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000737:chemistry; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D001152:Arsenicals; D002121:Calcium Channel Blockers; D001151:Arsenic
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