Higher long-term average corrected QT interval (tertile 3 vs tertile 1) was associated with increased risk of cardiac arrest (HR 1.66), heart failure (HR 1.62), and all-cause mortality (HR 1.24).
Cohort (n=61,455)
Do longitudinal QT interval dynamics from serial ECGs predict incident cardiovascular disease and all-cause mortality in a general healthcare population?
Longitudinal assessment of QT interval dynamics from serial ECGs improves the prediction of cardiovascular outcomes and all-cause mortality compared to single measurements.
Hazard Ratio: 1.66
Background Long QT has been associated with ventricular dysrhythmias, cardiovascular disease (CVD) mortality, and sudden cardiac death. However, no studies to date have investigated the dynamics of within-person QT change over time in relation to risk of incident CVD and all-cause mortality in a real-world setting. Methods and Results A cohort study among members of an integrated health care delivery system in Northern California including 61 455 people (mean age, 62 years; 60% women, 42% non-White) with 3 or more ECGs (baseline in 2005-2009; mean±SD follow-up time, 7.6±2.6 years). In fully adjusted models, tertile 3 versus tertile 1 of average QT corrected (using the Fridericia correction) was associated with cardiac arrest (hazard ratio HR, 1.66), heart failure (HR, 1.62), ventricular dysrhythmias (HR, 1.56), all CVD (HR, 1.31), ischemic heart disease (HR, 1.28), total stroke (HR, 1.18), and all-cause mortality (HR, 1.24). Tertile 3 versus tertile 2 of the QT corrected linear slope was associated with cardiac arrest (HR, 1.22), ventricular dysrhythmias (HR, 1.12), and all-cause mortality (HR, 1.09). Tertile 3 versus tertile 1 of the QT corrected root mean squared error was associated with ventricular dysrhythmias (HR, 1.34), heart failure (HR, 1.28), all-cause mortality (HR, 1.20), all CVD (HR, 1.14), total stroke (HR, 1.08), and ischemic heart disease (HR, 1.07). Conclusions Our results demonstrate improved predictive ability for CVD outcomes using longitudinal information from serial ECGs. Long-term average QT corrected was more strongly associated with CVD outcomes than the linear slope or the root mean squared error. This new evidence is clinically relevant because ECGs are frequently used, noninvasive, and inexpensive.
Mantri et al. (Tue,) conducted a cohort in Cardiovascular disease (n=61,455). Average corrected QT interval (tertile 3) vs. Tertile 1 was evaluated on Cardiac arrest (HR 1.66). Higher long-term average corrected QT interval (tertile 3 vs tertile 1) was associated with increased risk of cardiac arrest (HR 1.66), heart failure (HR 1.62), and all-cause mortality (HR 1.24).
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