Roy Beinart1, Yiyi Zhang2, João A C Lima3, David A Bluemke4, Elsayed Z Soliman5, Susan R Heckbert6, Wendy S Post3, Eliseo Guallar2, Saman Nazarian7. 1. Division of Cardiology, Johns Hopkins University, Baltimore, Maryland; Leviev Heart Center, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel. 2. Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland. 3. Division of Cardiology, Johns Hopkins University, Baltimore, Maryland. 4. Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland. 5. Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention and Department of Internal Medicine, Cardiology Section, Wake Forest School of Medicine, Winston-Salem, North Carolina. 6. Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, Washington. 7. Division of Cardiology, Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland. Electronic address: snazarian@jhmi.edu.
Abstract
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.
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.
Authors: Jacqueline M Dekker; Richard S Crow; Peter J Hannan; Evert G Schouten; Aaron R Folsom Journal: J Am Coll Cardiol Date: 2004-02-18 Impact factor: 24.094
Authors: Diane E Bild; David A Bluemke; Gregory L Burke; Robert Detrano; Ana V Diez Roux; Aaron R Folsom; Philip Greenland; David R Jacob; Richard Kronmal; Kiang Liu; Jennifer Clark Nelson; Daniel O'Leary; Mohammed F Saad; Steven Shea; Moyses Szklo; Russell P Tracy Journal: Am J Epidemiol Date: 2002-11-01 Impact factor: 4.897
Authors: Katherine A Moon; Yiyi Zhang; Eliseo Guallar; Kevin A Francesconi; Walter Goessler; Jason G Umans; Lyle G Best; Barbara V Howard; Richard B Devereux; Peter M Okin; Ana Navas-Acien Journal: Environ Pollut Date: 2018-05-26 Impact factor: 8.071
Authors: Yuko Y Inoue; Bharath Ambale-Venkatesh; Nathan Mewton; Gustavo J Volpe; Yoshiaki Ohyama; Ravi K Sharma; Colin O Wu; Chia-Ying Liu; David A Bluemke; Elsayed Z Soliman; João A C Lima; Hiroshi Ashikaga Journal: Radiology Date: 2016-10-13 Impact factor: 11.105
Authors: Itai M Magodoro; Alfred J Albano; Rahul Muthalaly; Bruce Koplan; Crystal M North; Dagmar Vořechovská; Jordan Downey; John Kraemer; Martino Vaglio; Fabio Badilini; Bernard Kakuhire; Alexander C Tsai; Mark J Siedner Journal: Glob Heart Date: 2018-12-21
Authors: Yoshihiro Tanaka; Joshua D Bundy; Norrina B Allen; S M Iftekhar Uddin; David I Feldman; Erin D Michos; Susan R Heckbert; Philip Greenland Journal: Am J Med Date: 2019-11-16 Impact factor: 4.965
Authors: Hilary F Armstrong; Gina S Lovasi; Elsayed Z Soliman; Susan R Heckbert; Bruce M Psaty; John H M Austin; Jerry A Krishnan; Eric A Hoffman; Craig Johnson; Matthew J Budoff; Karol E Watson; R Graham Barr Journal: Respir Med Date: 2016-12-08 Impact factor: 3.415
Authors: Chaudry N Majeed; Muhammad I Ahmad; Irfan Ahsan; Muhammad A Anees; Sanjay K Maheshwari; Elsayed Z Soliman Journal: Ann Noninvasive Electrocardiol Date: 2019-09-09 Impact factor: 1.468
Authors: Francesco Santoro; Natale Daniele Brunetti; Nicola Tarantino; Jorge Romero; Francesca Guastafierro; Armando Ferraretti; Luigi F M Di Martino; Riccardo Ieva; Pier Luigi Pellegrino; Matteo Di Biase; Luigi Di Biase Journal: Clin Cardiol Date: 2017-09-11 Impact factor: 2.882
Authors: Hanna Lenhoff; Börje Darpö; Alex Page; Jean Philippe Couderc; Per Tornvall; Mats Frick Journal: Ann Noninvasive Electrocardiol Date: 2021-02-25 Impact factor: 1.468