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Arsenic-Induced QT Dispersion is Associated with Atherosclerotic Diseases and Predicts Long-Term Cardiovascular Mortality in Subjects with Previous Exposure to Arsenic: A 17-Year Follow-Up Study

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Abstract

Chronic arsenic poisoning is a major worldwide public health problem. Recently, we had reported chronic arsenic poisoning was dose-dependently associated with ventricular abnormalities quantified by electrocardiographic QT prolongation linking to atherosclerotic diseases. An association of chronic arsenic poisoning with ventricular repolarization inhomogeneity quantified by QT dispersion (QTD) is of particular interest from a theoretical and practical perspective. We aimed to further elucidate (1) the association of chronic arsenic exposure with ventricular abnormalities quantified by QTD, (2) the association of QTD with atherosclerotic diseases and (3) the predictability of QTD for long-term mortality in subjects with chronic arsenic poisoning. We followed up 280 men and 355 women living in arseniasis-endemic area in southwestern coast in Taiwan for 17 years. QTD in electrocardiogram and carotid intima–media thickness by ultrasonography were measured. Coronary artery disease was diagnosed by an abnormal electrocardiogram and a definite history. Cumulative arsenic exposure was significantly associated with QTD showing a dose–response relationship (P < 0.001). Significant associations of the QTD with coronary artery disease and carotid atherosclerosis existed after adjustment for potential confounders in the multiple linear regression analysis (all P values < 0.05). In the multivariate Cox regression analyses, the hazard ratios (95% confidence interval, P value) of cumulative cardiovascular and all-cause mortality were 3.9 (2.1–6.2, P = 0.002) and 1.4 (0.9–2.3, P = 0.10), respectively, for QTD ≥ 65 ms compared with QTD < 65. QTD may be indicated as an early biomarker for atherosclerotic diseases and a significant and strong predictor of cardiovascular mortality in population with chronic arsenic exposure.

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Acknowledgments

This study was supported by grants NSC83-0412-B002-23, NSC91-2320-B002-075, NSC92-2320-B002-136, and NSC 92-2320-B002-135 from the National Science Council and DOH85-HR-503PL from Department of Health, Executive Yuan, Taiwan.

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Authors and Affiliations

  1. Department of Cardiology, Cardinal Tien Hospital, College of Medicine, Fu-Jen Catholic University, 362 Chung Cheng Road, Hsintien, Taipei, 23137, Taiwan

    Chih-Hao Wang

  2. Department of Internal Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan

    Chih-Hao Wang

  3. Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan

    Chi-Ling Chen

  4. Department of Public Health and Graduate Institute of Epidemiology, National Taiwan University, Taipei, Taiwan

    Chuhsing Kate Hsiao

  5. Department of Laboratory Medicine, National Taiwan University, Taipei, Taiwan

    Fu-Tien Chiang

  6. Genomics Research Center, Academia Sinica, Taipei, Taiwan

    Ling-I Hsu & Chien-Jen Chen

  7. School of Public Health, Taipei Medical University, Taipei, Taiwan

    Hung-Yi Chiou & Meei-Maan Wu

  8. Department of Public Health, School of Medicine, Taipei Medical University, Taipei, Taiwan

    Yu-Mei Hsueh

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  1. Chih-Hao Wang
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Wang, CH., Chen, CL., Hsiao, C.K. et al. Arsenic-Induced QT Dispersion is Associated with Atherosclerotic Diseases and Predicts Long-Term Cardiovascular Mortality in Subjects with Previous Exposure to Arsenic: A 17-Year Follow-Up Study. Cardiovasc Toxicol 10, 17–26 (2010). https://doi.org/10.1007/s12012-009-9059-x

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