The QT interval is associated with incident cardiovascular events: the MESA study
Roy Beinart1, Yiyi Zhang2, João A C Lima3
1Division of Cardiology, Johns Hopkins University, Baltimore, Maryland; Leviev Heart Center, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel.
Background:
Prolonged heart rate-corrected QT interval on electrocardiograms (ECGs) is associated with increased risk of myocardial infarction and cardiovascular disease (CVD)-related deaths in patients with prevalent coronary heart disease.
Objectives:
This study sought to examine the prognostic association between the baseline QT interval and incident cardiovascular events in individuals without prior known CVD.
Methods:
The corrected baseline 12-lead ECG QT interval duration (QTcorr) was determined by adjustment for age, sex, race/ethnicity, and RR interval duration in 6,273 participants in MESA (Multi-Ethnic Study of Atherosclerosis). Cox proportional hazards models adjusting for demographic and clinical risk factors were used to examine the association of baseline QTcorr with incident cardiovascular events.
Results:
The mean age at enrollment was 61.7 ± 10 years, and 53.4% of participants were women. Cardiovascular events occurred in 291 participants over a mean follow-up of 8.0 ± 1.7 years. Each 10-ms increase in the baseline QTcorr was associated with incident heart failure (hazard ratio [HR]: 1.25; 95% CI: 1.14 to 1.37), CVD events (HR: 1.12; 95% CI: 1.05 to 1.20), and stroke (HR: 1.19; 95% CI: 1.07 to 1.32) after adjustment for CVD risk factors and potential confounders. There was no evidence of interaction with sex or ethnicity.
Conclusions:
The QT interval was associated with incident cardiovascular events in middle-aged and older adults without prior CVD.
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