Association Between Heart Rate-corrected QT Interval and Severe Peripheral Arterial Disease in Patients with Type 2 Diabetes and Foot Ulcers:Aa Case Control Study

Abstract Background: Half of patients with diabetes and foot ulcers (DFUs) have co-existing peripheral arterial disease (PAD). Prolonged heart rate-corrected QT (QTc) interval was found to be associated with PAD in a general population. The goal of the present study was to investigate the relationship between QTc interval and PAD in patients with DFUs.Methods: The present multi-center cross-sectional study enrolled 281 patients with DFUs. Severity of PAD was classified as no-severe PAD group (no obvious abnormality or plaques) and severe PAD group (stenosis or occlusion) according to duplex ultrasonography. QTc was calculated according to the Bazett formula. The study population was divided into subgroups based on the QTc tertiles. Results: The patients with severe PAD had longer QTc interval (P = 0.004) and higher prevalence of prolonged QTc (P = 0.042) than those with no-severe PAD. After adjustment for gender and age, partial correlation analysis revealed positive relationship of QTc with prevalence of severe DFUs (r = 0.194, P = 0.001) and severe PAD (r = 0.118, P = 0.048). Univariate logistic analysis showed that the QTc was positively associated with severe PAD (odds ratio [OR] = 1.010, P = 0.014). Compared to those in lowest tertile of QTc, the ORs for severe PAD were increased significantly and independently for those in upper tertiles of QTc (both P < 0.05). Conclusions: Prolonged QTc interval was independently associated with severe PAD in patients with DFUs, which might indicate the worse progression of peripheral atherosclerosis in early stage for this population.