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Original research
Long QT syndrome is associated with an increased burden of diabetes, psychiatric and neurological comorbidities: a nationwide cohort study
  1. Peter Marstrand1,
  2. Juliane Theilade1,
  3. Charlotte Andersson1,
  4. Henning Bundgaard2,
  5. Peter E Weeke2,
  6. Jacob Tfelt-Hansen2,3,
  7. Camilla Jespersen2,
  8. Gunnar Gislason1,
  9. Christian Torp-Pedersen4,
  10. Jørgen K Kanters5 and
  11. Mads E Jørgensen1
  1. 1Department of Cardiology, Herlev-Gentofte Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
  2. 2Department of Cardiology, Rigshospitalet, University Hospital Copenhagen, Copenhagen, Denmark
  3. 3Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark
  4. 4Department of Health, Science and Technology, Aalborg University and Departments of Cardiology and Biostatistics/epidemiology, Aalborg University Hospital, Aalborg, Denmark
  5. 5Laboratory of Experimental Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to Dr Peter Marstrand; pmarstrand{at}hotmail.com

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.

  • long QT syndrome
  • comorbidity
  • diabetes
  • epilepsy
  • hearing loss

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors PM, MEJ, CA and JT contributed to the conception or design of the work and final approval of the version to be published. PM, MEJ, CJ contributed to the data collection. PM, MEJ, CA, JT, JKK, HB, CT-P and GG contributed to the data analysis and interpretation. PM and MEJ drafted the article. JT, CA, HB, PW, JT-H, CJ, GG, CT-P and JKK contributed to the critical revision of the article.

  • Funding This study was funded by he FUKAP foundation, A.P. Møller og Hustru Chastine Mc-Kinney Møllers Fond til almene Formaal, Købmand Sven Hansen og Hustru Ina Hansens Fond, Fondsbørsvekselerer Henry Hansen og hustrus legat, The Danish Heart Foundation (Grant number:17-R115-A7532-22065).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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