Circulation, Vol 90, 779-785, Copyright © 1994 by American Heart Association
JM Dekker, EG Schouten, P Klootwijk, J Pool and D Kromhout
BACKGROUND: Heart-rate-adjusted QT-interval (QTc) is prognostic of sudden
death in myocardial infarction patients. So far, population studies have
yielded conflicting results on the predictive value of QTc for coronary
heart disease morbidity and mortality. Therefore, we investigated this in a
longitudinal study of middle-aged and elderly men. METHODS AND RESULTS:
From 1960 to 1985, 877 middle-aged men were followed and repeatedly
examined in the Zutphen Study. In 1985 the remaining cohort was extended to
835 elderly men from the same birth cohort and followed until 1990. Men
with prolonged QTc (420 ms1/2 or more) had a higher risk of myocardial
infarction and coronary heart disease death relative to men with QTc less
than 385 ms1/2. Age- adjusted coronary heart disease mortality rate ratios
were 4.3 (95% confidence interval, 1.3 to 13.8) in middle-aged men and 3.3
(95% confidence interval, 1.0 to 11.6) in elderly men. These associations
could not be attributed to prevalent heart disease and were independent of
other cardiovascular risk factors. CONCLUSIONS: These results indicate that
within the normal range of QTc in the general population, men with long QTc
are at higher risk for coronary heart disease. Because QTc is easily
determined, it may provide a valuable contribution to risk stratification.
ARTICLES
Association between QT interval and coronary heart disease in middle- aged and elderly men. The Zutphen Study
Department of Epidemiology and Public Health, Agricultural University Wageningen, The Netherlands.
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