title: The QT interval is associated with incident cardiovascular events: the MESA study.
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.
  
  
  OBJECTIVE
  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.affiliation: Division of Cardiology, Johns Hopkins University, Baltimore, Maryland; Leviev Heart Center, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Roy
authors.initials: R
authors.lastname: Beinart
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Yiyi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
authors.forename: João A C
authors.initials: JA
authors.lastname: Lima
authors.affiliation: Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: 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.
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
authors.affiliation: Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, Washington.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.affiliation: Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
authors.affiliation: Division of Cardiology, Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland. Electronic address: snazarian@jhmi.edu.
authors.forename: Saman
authors.initials: S
authors.lastname: Nazarian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology*; D004562:Electrocardiography / Q000379:methods; D005006:Ethnicity / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D057566:Self Report
keywords: QT interval; cardiovascular disease; coronary heart disease; heart failure; myocardial infarction; stroke