Association between QT interval and coronary heart disease in middle-aged and elderly men. The Zutphen Study.
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Key result
Men with a prolonged heart-rate-adjusted QT interval (≥420 ms1/2) had a significantly higher risk of coronary heart disease mortality compared to those with a short QTc (<385 ms1/2), with a rate ratio of 4.3 in middle-aged men.
Why the study?
Does prolonged QTc predict myocardial infarction and coronary heart disease death in middle-aged and elderly men?
Population
877 middle-aged men followed from 1960 to 1985, and an extended cohort of 835 elderly men followed from 1985…
Comparison
Prolonged QTc (≥420 ms1/2) vs QTc less than 385 ms1/2
Design
Cohort
Follow-up
Up to 25 years for middle-aged men, and 5 years for…
Authors
Discussion
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Implication
Prolonged QTc may identify men at elevated CHD mortality risk; leaves open its incremental value in modern risk models.
Study Design
Type
Cohort (n=1,588)
Multicenter
No
Structured PICO
Does prolonged QTc predict myocardial infarction and coronary heart disease death in middle-aged and elderly men?
P
Population
1,588 middle-aged and elderly men from the general population of Zutphen, free of prior myocardial infarction, followed for up to 25 years to assess cardiovascular outcomes.
E
Exposure
Prolonged QTc (≥420 ms1/2)
C
Comparator
QTc less than 385 ms1/2
O
Outcome
Myocardial infarction and coronary heart disease deathhard clinical
Main Result
Relative Risk: 4.3 (95% CI 1.3–13.8)
Absolute Event Rate: 21.9% vs 11.1%
Prolonged QTc within the normal range is an independent predictor of myocardial infarction and coronary heart disease death in middle-aged and elderly men, suggesting its utility in risk stratification.
Limitations
- Measurement of QT interval by a single observer
- QT interval not measured in all available leads
- Ascertainment of sudden death prone to misclassification
- Lack of information on drug use before 1985
- Potential confounding by subclinical heart disease
Cite This Study
Dekker et al. (1994) conducted a cohort in General population (n=1,588). Prolonged heart-rate-adjusted QT interval (≥420 ms1/2) vs. Short QT interval (<385 ms1/2) was evaluated on Coronary heart disease mortality (RR 4.3, 95% CI 1.3-13.8). Men with a prolonged heart-rate-adjusted QT interval (≥420 ms1/2) had a significantly higher risk of coronary heart disease mortality compared to those with a short QTc (<385 ms1/2), with a rate ratio of 4.3 in middle-aged men.
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