Long QT syndrome is associated with an increased burden of diabetes, psychiatric and neurological comorbidities: A nationwide cohort study

Peter Marstrand; Juliane Theilade; Charlotte Andersson; Henning Bundgaard; Peter E. Weeke; Jacob Tfelt-Hansen; Camilla Jespersen; Gunnar Gislason; Christian Torp-Pedersen; Jørgen K. Kanters; Mads E. Jørgensen

doi:10.1136/openhrt-2019-001161

Long QT syndrome is associated with an increased burden of diabetes, psychiatric and neurological comorbidities: A nationwide cohort study

Peter Marstrand^*, Juliane Theilade, Charlotte Andersson, Henning Bundgaard, Peter E. Weeke, Jacob Tfelt-Hansen, Camilla Jespersen, Gunnar Gislason, Christian Torp-Pedersen, Jørgen K. Kanters, Mads E. Jørgensen

^*Corresponding author af dette arbejde

3 Citationer (Scopus)

Abstract

Objective Studies have suggested a shared genetic aetiology between congenital long QT syndrome (LQTS) and diabetes, epilepsy and mental disorders. We investigated the prevalence of metabolic, neurological and psychiatric comorbidities in LQTS patients. Methods This retrospective cohort study was based on data from nationwide Danish registries, 2003-2017. LQTS patients were matched 1:5 with controls on sex and age. Results We matched 463 LQTS patients with 2315 controls from the background population. Mean age was 35.7 (SD 21.0) years, and 38% were males in both groups. LQTS patients had a higher prevalence of atrial fibrillation (6.5% vs 2.3%, p<0.001), diabetes (3.7% vs 1.8 %, p=0.011) and hearing loss (3.2% vs 1.7%, p=0.027). LQTS patients had a higher prevalence of psychiatric disorders overall (13.0% vs 9.1%, p=0.01) but the difference could not be attributed to a specific psychiatric disease subgroup. LQTS patients had a higher prevalence of neurological disorders (22.0% vs 13.2%, p<0.001), largely driven by epilepsy (6.7% vs 1.6%, p<0.001). In 20/27 (74%) of the LQTS patients, the epilepsy diagnosis did not reappear in the registries after the LQTS diagnosis was established. Conclusions In this nationwide cohort, patients with LQTS had a significantly increased burden of diabetes, neurological and psychiatric comorbidities, compared with the background population. The higher prevalence of neurological comorbidities was largely driven by epilepsy, despite a high rate of potentially misdiagnosed patients prior to LQTS diagnosis. Our data support that LQTS may be considered a multiorgan disease and suggest that patient management should be adjusted accordingly.

Originalsprog	Engelsk
Artikelnummer	e001161
Tidsskrift	Open Heart
Vol/bind	6
Udgave nummer	2
Antal sider	8
ISSN	2398-595X
DOI	https://doi.org/10.1136/openhrt-2019-001161
Status	Udgivet - 2019

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10.1136/openhrt-2019-001161Licens: CC BY-NC

OA-Long QT syndrome is associated withForlagets udgivne version, 816 KBLicens: CC BY-NC

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Marstrand, P., Theilade, J., Andersson, C., Bundgaard, H., Weeke, P. E., Tfelt-Hansen, J., Jespersen, C., Gislason, G., Torp-Pedersen, C., Kanters, J. K., & Jørgensen, M. E. (2019). Long QT syndrome is associated with an increased burden of diabetes, psychiatric and neurological comorbidities: A nationwide cohort study. Open Heart, 6(2), Artikel e001161. https://doi.org/10.1136/openhrt-2019-001161

Marstrand, P, Theilade, J, Andersson, C, Bundgaard, H, Weeke, PE, Tfelt-Hansen, J, Jespersen, C, Gislason, G, Torp-Pedersen, C, Kanters, JK & Jørgensen, ME 2019, 'Long QT syndrome is associated with an increased burden of diabetes, psychiatric and neurological comorbidities: A nationwide cohort study', Open Heart, bind 6, nr. 2, e001161. https://doi.org/10.1136/openhrt-2019-001161

@article{86a4fc548d5f413796e8ca11982a14c7,

title = "Long QT syndrome is associated with an increased burden of diabetes, psychiatric and neurological comorbidities: A nationwide cohort study",

abstract = "Objective Studies have suggested a shared genetic aetiology between congenital long QT syndrome (LQTS) and diabetes, epilepsy and mental disorders. We investigated the prevalence of metabolic, neurological and psychiatric comorbidities in LQTS patients. Methods This retrospective cohort study was based on data from nationwide Danish registries, 2003-2017. LQTS patients were matched 1:5 with controls on sex and age. Results We matched 463 LQTS patients with 2315 controls from the background population. Mean age was 35.7 (SD 21.0) years, and 38% were males in both groups. LQTS patients had a higher prevalence of atrial fibrillation (6.5% vs 2.3%, p<0.001), diabetes (3.7% vs 1.8 %, p=0.011) and hearing loss (3.2% vs 1.7%, p=0.027). LQTS patients had a higher prevalence of psychiatric disorders overall (13.0% vs 9.1%, p=0.01) but the difference could not be attributed to a specific psychiatric disease subgroup. LQTS patients had a higher prevalence of neurological disorders (22.0% vs 13.2%, p<0.001), largely driven by epilepsy (6.7% vs 1.6%, p<0.001). In 20/27 (74%) of the LQTS patients, the epilepsy diagnosis did not reappear in the registries after the LQTS diagnosis was established. Conclusions In this nationwide cohort, patients with LQTS had a significantly increased burden of diabetes, neurological and psychiatric comorbidities, compared with the background population. The higher prevalence of neurological comorbidities was largely driven by epilepsy, despite a high rate of potentially misdiagnosed patients prior to LQTS diagnosis. Our data support that LQTS may be considered a multiorgan disease and suggest that patient management should be adjusted accordingly.",

keywords = "comorbidity, diabetes, epilepsy, hearing loss, long QT syndrome",

author = "Peter Marstrand and Juliane Theilade and Charlotte Andersson and Henning Bundgaard and Weeke, {Peter E.} and Jacob Tfelt-Hansen and Camilla Jespersen and Gunnar Gislason and Christian Torp-Pedersen and Kanters, {J{\o}rgen K.} and J{\o}rgensen, {Mads E.}",

year = "2019",

doi = "10.1136/openhrt-2019-001161",

language = "English",

volume = "6",

journal = "Open Heart",

issn = "2398-595X",

publisher = "BMJ",

number = "2",

}

TY - JOUR

T1 - Long QT syndrome is associated with an increased burden of diabetes, psychiatric and neurological comorbidities

T2 - A nationwide cohort study

AU - Marstrand, Peter

AU - Theilade, Juliane

AU - Andersson, Charlotte

AU - Bundgaard, Henning

AU - Weeke, Peter E.

AU - Tfelt-Hansen, Jacob

AU - Jespersen, Camilla

AU - Gislason, Gunnar

AU - Torp-Pedersen, Christian

AU - Kanters, Jørgen K.

AU - Jørgensen, Mads E.

PY - 2019

Y1 - 2019

N2 - Objective Studies have suggested a shared genetic aetiology between congenital long QT syndrome (LQTS) and diabetes, epilepsy and mental disorders. We investigated the prevalence of metabolic, neurological and psychiatric comorbidities in LQTS patients. Methods This retrospective cohort study was based on data from nationwide Danish registries, 2003-2017. LQTS patients were matched 1:5 with controls on sex and age. Results We matched 463 LQTS patients with 2315 controls from the background population. Mean age was 35.7 (SD 21.0) years, and 38% were males in both groups. LQTS patients had a higher prevalence of atrial fibrillation (6.5% vs 2.3%, p<0.001), diabetes (3.7% vs 1.8 %, p=0.011) and hearing loss (3.2% vs 1.7%, p=0.027). LQTS patients had a higher prevalence of psychiatric disorders overall (13.0% vs 9.1%, p=0.01) but the difference could not be attributed to a specific psychiatric disease subgroup. LQTS patients had a higher prevalence of neurological disorders (22.0% vs 13.2%, p<0.001), largely driven by epilepsy (6.7% vs 1.6%, p<0.001). In 20/27 (74%) of the LQTS patients, the epilepsy diagnosis did not reappear in the registries after the LQTS diagnosis was established. Conclusions In this nationwide cohort, patients with LQTS had a significantly increased burden of diabetes, neurological and psychiatric comorbidities, compared with the background population. The higher prevalence of neurological comorbidities was largely driven by epilepsy, despite a high rate of potentially misdiagnosed patients prior to LQTS diagnosis. Our data support that LQTS may be considered a multiorgan disease and suggest that patient management should be adjusted accordingly.

AB - Objective Studies have suggested a shared genetic aetiology between congenital long QT syndrome (LQTS) and diabetes, epilepsy and mental disorders. We investigated the prevalence of metabolic, neurological and psychiatric comorbidities in LQTS patients. Methods This retrospective cohort study was based on data from nationwide Danish registries, 2003-2017. LQTS patients were matched 1:5 with controls on sex and age. Results We matched 463 LQTS patients with 2315 controls from the background population. Mean age was 35.7 (SD 21.0) years, and 38% were males in both groups. LQTS patients had a higher prevalence of atrial fibrillation (6.5% vs 2.3%, p<0.001), diabetes (3.7% vs 1.8 %, p=0.011) and hearing loss (3.2% vs 1.7%, p=0.027). LQTS patients had a higher prevalence of psychiatric disorders overall (13.0% vs 9.1%, p=0.01) but the difference could not be attributed to a specific psychiatric disease subgroup. LQTS patients had a higher prevalence of neurological disorders (22.0% vs 13.2%, p<0.001), largely driven by epilepsy (6.7% vs 1.6%, p<0.001). In 20/27 (74%) of the LQTS patients, the epilepsy diagnosis did not reappear in the registries after the LQTS diagnosis was established. Conclusions In this nationwide cohort, patients with LQTS had a significantly increased burden of diabetes, neurological and psychiatric comorbidities, compared with the background population. The higher prevalence of neurological comorbidities was largely driven by epilepsy, despite a high rate of potentially misdiagnosed patients prior to LQTS diagnosis. Our data support that LQTS may be considered a multiorgan disease and suggest that patient management should be adjusted accordingly.

KW - comorbidity

KW - diabetes

KW - epilepsy

KW - hearing loss

KW - long QT syndrome

U2 - 10.1136/openhrt-2019-001161

DO - 10.1136/openhrt-2019-001161

M3 - Journal article

C2 - 31749975

AN - SCOPUS:85074680971

SN - 2398-595X

VL - 6

JO - Open Heart

JF - Open Heart

IS - 2

M1 - e001161

ER -

Long QT syndrome is associated with an increased burden of diabetes, psychiatric and neurological comorbidities: A nationwide cohort study

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