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Clinical Investigations: CARDIOLOGY |

Increased Prevalence of Third-Degree Atrioventricular Block in Patients With Type II Diabetes Mellitus*

Mohammad-Reza Movahed, MD, PhD; Mehrtash Hashemzadeh, MS; M. Mazen Jamal, MD, MPH
Author and Funding Information

*From the Division of Cardiology (Dr. Movahed), University of California, Irvine, Medical Center, Orange; and Long Beach Veteran Administration Medical Center (Mr. Hashemzadeh and Dr. Jamal), Long Beach, CA.

Correspondence to: M. Reza Movahed, MD, PhD, FCCP, Assistant Clinical Professor, University of California, Irvine, Medical Center, Department of Medicine, Division of Cardiology, 101 The City Dr, Bldg 53, Rm 100, Orange, CA 92868-4080; e-mail: rmova@aol.com



Chest. 2005;128(4):2611-2614. doi:10.1378/chest.128.4.2611
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Background: Diabetes mellitus (DM) is a major risk for cardiovascular disease and mortality. There is some evidence that third-degree atrioventricular (AV) block occurs more commonly in patients with DM. In this study, we evaluated any possible association between DM and third-degree AV block using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in a very large inpatient database.

Method: We used patient treatment files containing discharge diagnoses using ICD-9 codes of inpatient treatment from all Veterans Health Administration hospitals. The cohort was stratified using the ICD-9-CM code for DM (n = 293,124), a control group with hypertension but no DM (n = 552,623), and the ICD-9 code for third-degree AV block (426.0) and smoking (305.1, V15.82). We performed multivariate analysis adjusting for coronary artery disease, congestive heart failure, smoking, and hyperlipidemia. Continuous and binary variables were analyzed using χ2 and Fisher exact tests.

Results: Third-degree AV block diagnosis was present in 3,240 of DM patients (1.1%) vs 3,367 patients (0.6%) in the control group. Using multivariate analysis, DM remained strongly associated with third-degree AV block (odds ratio, 3.1; 95% confidential interval, 3.0 to 3.3; p < 0.0001).

Conclusion: Third-degree AV block occurs significantly more in patients with DM. This finding may, in part, explain the high cardiovascular mortality in DM patients.


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