Effect of Statin Therapy in Tpe-Interval and Tpe/Qtc Ratio in Patients with Familial Hypercholesterolemia

Mehmet Küçükosmanoğlu; Salih Kılıç; Erhan Saraçoğlu; Yusuf Çekici; Ertan Vuruşkan; Meral Kayıkcıoğlu

doi:10.5152/eurjther.2020.19018

Authors

Mehmet Küçükosmanoğlu Department of Cardiology, Health Sciences University, Adana Research and Training Hospital, Adana https://orcid.org/0000-0001-9186-3642
Salih Kılıç Department of Cardiology, Health Sciences University, Adana Research and Training Hospital, Adana https://orcid.org/0000-0002-3579-3747
Erhan Saraçoğlu Department of Cardiology, Health Sciences University, Yıldırım Beyazıt Dışkapı Research and Training Hospital, Ankara https://orcid.org/0000-0003-3797-512X
Yusuf Çekici Department of Cardiology, Health Sciences University, Mehmet Akif İnan Research and Training Hospital, Şanlıurfa https://orcid.org/0000-0002-4585-3707
Ertan Vuruşkan Department of Cardiology, Gaziantep University School of Medicine, Gaziantep https://orcid.org/0000-0001-6820-3582
Meral Kayıkcıoğlu Department of Cardiology, Ege University School of Medicine, İzmir https://orcid.org/0000-0003-3692-5227

DOI:

https://doi.org/10.5152/eurjther.2020.19018

Keywords:

Electrocardiography, familial hypercholesterolemia, Tpe/QTc ratio, Tpe-interval, ventricular arrhythmias

Abstract

Objective: Studies have shown that hypercholesterolemia can induce ventricular vulnerability to fibrillation, and statin therapy exerts antiarrhythmic effects. In the present study, we investigated the relationship between arrhythmogenic substrate and familial hypercholesterolemia (FH) with regard to statin therapy.
Methods: We evaluated 46 statin-naive patients (41±12 years) with FH, and 46 healthy subjects (40±8 years) prospectively. Electrocardiography (ECG) of patients were compared before and after 6 months of intensive statin therapy and with control groups. The ECG parameters were calculated by two experienced cardiologists who blinded to each other’s findings.
Results: There were no significant differences found between groups’ baseline characteristics. Total cholesterol (343±49 mg/dL vs. 161±12 mg/dL; p<0.001) and low-density lipoprotein-cholesterol (LDL-C) (260±42 vs. 95±13; p<0.001) levels were significantly higher in FH group. Both total cholesterol (343±49 vs. 206±45; p<0.001) and LDL-C (260±42 vs. 138±40; p<0.001)levels were decreased after statin therapy. Both mean baseline Tpe-interval (90.7±9.3 ms vs. 77.6±7.3 ms; p<0.001) and Tpe/QTc ratio (0.219±0.02 vs. 0.193±0.01; p<0.001) were found to be significantly higher in FH group than control subjects. Afterstatin therapy, Tpe-interval (90.7±9.3 ms vs. 81.3±8.3 ms; p<0.001) and Tpe/QTc ratio (0.219±0.02 vs. 0.201±0.02; p<0.001)were significantly decreased. Compared to the control group, Tpe-interval (81.3±8.3 ms vs. 77.6±7.3 ms; p=0.027) and Tpe/QTc (0.206±0.02 vs. 0.193±0.01; p=0.021) ratio remained higher in FH patients after statin therapy. There was a strong andpositive correlation between basal LDL-C and Tpe-interval (r=0.740; p<0.001) and Tpe/QTc ratio (r=0.597; p<0.001)
Conclusion: This study showed that Tpe-interval and Tpe/QTc ratio on ECG were significantly prolonged in FH patients and improved with intense statin therapy by lowering LDL-C.

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