Determinants of developing widened spatial QRS-T angle in HIV-infected individuals: Results from the Strategies for Management of Antiretroviral Therapy [SMART] Study

Farah Z Dawood; Mollie P Roediger; Greg Grandits; Dery Miller; Martin Fisher; Zhu-Ming Zhang; Sally Hodder; Jennifer F Hoy; Jens D Lundgren; James D Neaton; Elsayed Z Soliman; INSIGHT SMART Study Group

doi:10.1016/j.jelectrocard.2013.12.001

Determinants of developing widened spatial QRS-T angle in HIV-infected individuals: Results from the Strategies for Management of Antiretroviral Therapy [SMART] Study

Farah Z Dawood, Mollie P Roediger, Greg Grandits, Dery Miller, Martin Fisher, Zhu-Ming Zhang, Sally Hodder, Jennifer F Hoy, Jens D Lundgren, James D Neaton, Elsayed Z Soliman, INSIGHT SMART Study Group

Department of Clinical Medicine

4 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Journal of Electrocardiology
Volume	47
Issue number	2
Pages (from-to)	264-271
Number of pages	8
ISSN	0022-0736
DOIs	https://doi.org/10.1016/j.jelectrocard.2013.12.001
Publication status	Published - 11 Jan 2014

Keywords

Adult
Anti-HIV Agents
Arrhythmias, Cardiac
C-Reactive Protein
Electrocardiography
Female
HIV Infections
Heart Conduction System
Humans
Male
Risk Factors
Sex Factors
Smoking

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jelectrocard.2013.12.001

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Dawood, F. Z., Roediger, M. P., Grandits, G., Miller, D., Fisher, M., Zhang, Z-M., Hodder, S., Hoy, J. F., Lundgren, J. D., Neaton, J. D., Soliman, E. Z., & INSIGHT SMART Study Group (2014). Determinants of developing widened spatial QRS-T angle in HIV-infected individuals: Results from the Strategies for Management of Antiretroviral Therapy [SMART] Study. Journal of Electrocardiology, 47(2), 264-271. https://doi.org/10.1016/j.jelectrocard.2013.12.001

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 et al.

In: Journal of Electrocardiology, Vol. 47, No. 2, 11.01.2014, p. 264-271.

Research output: Contribution to journal › Journal article › Research › peer-review

Dawood, FZ, Roediger, MP, Grandits, G, Miller, D, Fisher, M, Zhang, Z-M, Hodder, S, Hoy, JF, Lundgren, JD, Neaton, JD, Soliman, EZ & INSIGHT SMART Study Group 2014, 'Determinants of developing widened spatial QRS-T angle in HIV-infected individuals: Results from the Strategies for Management of Antiretroviral Therapy [SMART] Study', Journal of Electrocardiology, vol. 47, no. 2, pp. 264-271. https://doi.org/10.1016/j.jelectrocard.2013.12.001

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title = "Determinants of developing widened spatial QRS-T angle in HIV-infected individuals: Results from the Strategies for Management of Antiretroviral Therapy [SMART] Study",

abstract = "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.",

keywords = "Adult, Anti-HIV Agents, Arrhythmias, Cardiac, C-Reactive Protein, Electrocardiography, Female, HIV Infections, Heart Conduction System, Humans, Male, Risk Factors, Sex Factors, Smoking",

author = "Dawood, {Farah Z} and Roediger, {Mollie P} and Greg Grandits and Dery Miller and Martin Fisher and Zhu-Ming Zhang and Sally Hodder and Hoy, {Jennifer F} and Lundgren, {Jens D} and Neaton, {James D} and Soliman, {Elsayed Z} and {INSIGHT SMART Study Group}",

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doi = "10.1016/j.jelectrocard.2013.12.001",

language = "English",

volume = "47",

pages = "264--271",

journal = "Journal of Electrocardiology",

issn = "0022-0736",

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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

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

SN - 0022-0736

VL - 47

SP - 264

EP - 271

JO - Journal of Electrocardiology

JF - Journal of Electrocardiology

IS - 2

ER -

Determinants of developing widened spatial QRS-T angle in HIV-infected individuals: Results from the Strategies for Management of Antiretroviral Therapy [SMART] Study

Abstract

Keywords

UN SDGs

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