Sudden Cardiac Death in Taiwan
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概要
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Data from a nationwide registration in the recipients of ICD revealed that the ICD patients in Taiwan had a higher incidence of normal heart compared to the Western patients from the CIDS, the AVID and the CASH trials. The higher percentage of patients presenting sudden cardiac death (SCD) without structural heart diseases suggests that genetic factors might play an important role in triggering lethal ventricular arrhythmias in this patient subset. Apart from the rare disease-causing mutations in ion channels, genetic polymorphism in NOS1AP has been associated with QTc prolongation and SCD in Western populations. To investigate whether NOS1AP variants are associated with QTc prolongation and exert synergistic effects on concomitant use of a QT-altering medication in Taiwanese patients. We genotyped two NOS1AP SNPs, rs10918594 and rs10494366, in 111 men who underwent a 12-lead ECG examination at baseline and 36.5±8.5 days after methadone treatment for heroin-dependence. At baseline, homozygous rs10918594C>G variant was associated with an increase in QTc of 11.6 ms (95% confidence interval [CI]: 0.6–22.6 ms, p=0.0397) compared to the reference alleles. The magnitude of QTc lengthening increased to 17.0 ms (95% CI: 2.0–31.9 ms, p=0.0275) after initiating methadone treatment. However, rs10494366 variant was not associated with QTc prolongation before and after methadone treatment. Our results showed that homozygous rs10918594C>G variant of NOS1AP potentiates QTc prolongation in heroin-addicted patients undergoing methadone treatment, which may lead to increased risks for arrhythmia and SCD in this particular Taiwanese population.