Key result
Men with an increase in QRS duration of ≥8 ms between ages 50 and 60 had a 56% increased risk of major cardiovascular events during an 11-year follow-up compared to those with an increase of <4 ms (HR 1.56).
Why the study?
Changes in QRS duration over time and their predictive value for cardiovascular disease in the general population are poorly studied.
Does an increase in QRS duration from age 50 to 60 predict major cardiovascular events in a general male population?
Cohort (n=585)
No
Does an increase in QRS duration from age 50 to 60 predict major cardiovascular events in a general male population?
Hazard Ratio: 1.56 (95% CI 1.07–2.27)
Absolute Event Rate: 33.3% vs 22.6%
p-value: p=0.022
An increase in QRS duration of ≥8 ms over a 10-year period in middle-aged men is an independent predictor of major cardiovascular events.
QRS widening ≥8 ms may flag higher MACE risk in middle-aged men; leaves open whether serial ECGs refine risk stratification beyond standard factors.
The QRS complex has been shown to be a prognostic marker in coronary artery disease. However, the changes in QRS duration over time, and its predictive value for cardiovascular disease in the general population is poorly studied. So we aimed to explore if increased QRS duration from the age of 50-60 is associated with increased risk of major cardiovascular events during a further follow-up to age 71. A random population sample of 798 men born in 1943 were examined in 1993 at 50 years of age, and re-examined in 2003 at age 60 and 2014 at age 71. Participants who developed cardiovascular disease before the re-examination in 2003 (n = 86) or missing value of QRS duration in 2003 (n = 127) were excluded. ΔQRS was defined as increase in QRS duration from age 50 to 60. Participants were divided into three groups: group 1: ΔQRS < 4 ms, group 2: 4 ms ≤ ΔQRS < 8 ms, group 3: ΔQRS ≥ 8 ms. Endpoints were major cardiovascular events. And we found compared with men in group 1 (ΔQRS < 4 ms), men with ΔQRS ≥ 8 ms had a 56% increased risk of MACE during follow-up to 71 years of age after adjusted for BMI, systolic blood pressure, smoking, hyperlipidemia, diabetes and heart rate in a multivariable Cox regression analysis (HR 1.56, 95% CI:1.07-2.27, P = 0.022). In conclusion, in this longitudinal follow-up over a decade QRS duration increased in almost two out of three men between age 50 and 60 and the increased QRS duration in middle age is an independent predictor of major cardiovascular events.
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Chen et al. (2021) conducted a cohort in General population (n=585). Increase in QRS duration ≥ 8 ms (ΔQRS ≥ 8 ms) vs. Increase in QRS duration < 4 ms (ΔQRS < 4 ms) was evaluated on Major adverse cardiovascular event (MACE) (HR 1.56, 95% CI 1.07-2.27, p=0.022). Men with an increase in QRS duration of ≥8 ms between ages 50 and 60 had a 56% increased risk of major cardiovascular events during an 11-year follow-up compared to those with an increase of <4 ms (HR 1.56).
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