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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Torsades de pointes following acute myocardial infarction: Evidence for a deadly link with a common genetic variant
Heart Rhythm, Volume 9, No. 7, Year 2012
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Description
BACKGROUND: Although QT prolongation following myocardial infarction (MI) is generally moderate, cases with marked QT prolongation leading to life-threatening torsades de pointes (TdP) have been described. OBJECTIVE: To investigate the genetic substrate of this phenomenon. METHODS: We studied 13 patients who developed TdP in the subacute phase of MI (2-11 days) and a group of 133 ethnically matched controls with uncomplicated MI. Long QT syndrome genes and the KCNH2-K897T polymorphism were screened by using denaturing high-performance liquid chromatography plus direct sequencing and a specific TaqMan assay, respectively. RESULTS: Two of the 13 patients (15%) who presented with QT prolongation and TdP were found to carry long QT syndrome mutations (KCNH2-R744X and SCN5A-E446K). Nine of the remaining 11 patients (82%) carried the KCNH2-K897T polymorphism, which was present in 35% of the controls (P = .0035). Thus, patients with an acute MI carrying the KCNH2-K897T polymorphism had an 8-fold greater risk of experiencing TdP compared with controls (95% confidence interval = 2-40). CONCLUSIONS: Our data suggest that the common K897T polymorphism is associated with an increased risk of TdP developing in the subacute phase of MI. Our findings support the concept that the electrical remodeling associated with this healing phase of MI may unmask a genetic substrate predisposing to a time-limited development of life-threatening arrhythmias. They also provide the first line of evidence in support of the hypothesis that a common polymorphism, previously described as a modifier of the severity of LQTS, may increase the risk of life-threatening arrhythmias in a much more prevalent cardiac disease such as myocardial infarction. © 2012 Heart Rhythm Society. All rights reserved.
Authors & Co-Authors
CROTTI, L.
Italy, Pavia
Università Degli Studi Di Pavia
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Germany, Oberschleissheim
Helmholtz Center Munich German Research Center for Environmental Health
Hu, Dan
United States, Utica
Masonic Medical Research Laboratory
Barajas-Martínez, Héctor M.
United States, Utica
Masonic Medical Research Laboratory
De Ferrari, Gaetano Maria
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Oliva, Antonio
United States, Utica
Masonic Medical Research Laboratory
Italy, Rome
Università Cattolica Del Sacro Cuore, Facoltà Di Medicina e Chirurgia
Insolia, Roberto
Italy, Pavia
Università Degli Studi Di Pavia
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Pollevick, Guido D.
United States, Utica
Masonic Medical Research Laboratory
Dagradi, Federica
Italy, Pavia
Università Degli Studi Di Pavia
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Guerchicoff, Alejandra
United States, Utica
Masonic Medical Research Laboratory
Greco, Federica
Italy, Pavia
Università Degli Studi Di Pavia
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Schwartz, Peter J.
Italy, Pavia
Università Degli Studi Di Pavia
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
South Africa, Cape Town
University of Cape Town
South Africa, Stellenbosch
Stellenbosch University
Saudi Arabia, Riyadh
College of Medicine
Viskin, Sami
Israel, Tel Aviv-yafo
Tel Aviv University
Antzelevitch, Charles
United States, Utica
Masonic Medical Research Laboratory
Statistics
Citations: 42
Authors: 13
Affiliations: 9
Identifiers
Doi:
10.1016/j.hrthm.2012.02.014
ISSN:
15475271
e-ISSN:
15563871
Research Areas
Genetics And Genomics
Noncommunicable Diseases