Author + information
- Received June 21, 2014
- Accepted August 6, 2014
- Published online November 18, 2014.
- Roy Beinart, MD∗,†,
- Yiyi Zhang, PhD‡,
- João A.C. Lima, MD∗,
- David A. Bluemke, MD, PhD§,
- Elsayed Z. Soliman, MD, MSc, MS‖,
- Susan R. Heckbert, MD, PhD¶,
- Wendy S. Post, MD, MS∗,
- Eliseo Guallar, MD, DrPH‡ and
- Saman Nazarian, MD, PhD∗,‡∗ ()
- ∗Division of Cardiology, Johns Hopkins University, Baltimore, Maryland
- †Leviev Heart Center, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
- ‡Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland
- §Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland
- ‖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
- ¶Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, Washington
- ↵∗Reprint requests and correspondence:
Dr. Saman Nazarian, Division of Cardiology, Johns Hopkins University, 600 North Wolfe Street, Carnegie 592A, Baltimore, Maryland 21287.
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.
MESA (Multi-Ethnic Study of Atherosclerosis) was funded by grants N01-HC-95159 through N01-HC95169 from the National Heart, Lung, and Blood Institute. The contents of this paper are the responsibility of the authors and do not necessarily represent the official views of the National Institute of Health (NIH). Dr. Nazarian is funded by NIH grants K23HL089333 and R01HL116280; is a scientific advisor to Biosense Webster Inc.; and is the principal investigator for research funding to Johns Hopkins University from Biosense Webster, Inc. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. P. E. Shah, MD, served as Guest Editor for this article.
- Received June 21, 2014.
- Accepted August 6, 2014.
- American College of Cardiology Foundation