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

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

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 languageEnglish (US)
Pages (from-to)264-271
Number of pages8
JournalJournal of Electrocardiology
Volume47
Issue number2
DOIs
StatePublished - 2014

Bibliographical note

Funding Information:
The SMART study was sponsored by the National Institute of Allergy and Infectious Disease , National Institutes of Health (grants U01AI042170, U01AI046362, and U01AI068641 ).

Keywords

  • Cardiovascular disease
  • Electrocardiogram
  • HIV/AIDS
  • Spatial QRS-T angle

Fingerprint Dive into the research topics of 'Determinants of developing widened spatial QRS-T angle in HIV-infected individuals: Results from the Strategies for Management of Antiretroviral Therapy [SMART] Study'. Together they form a unique fingerprint.

Cite this