QT间期与心血管事件发生相关：多族裔动脉粥样硬化研究（MESA）
The QT interval is associated with incident cardiovascular events: the MESA study.
作者信息
Beinart Roy, Zhang Yiyi, Lima João A C, Bluemke David A, Soliman Elsayed Z, Heckbert Susan R, Post Wendy S, Guallar Eliseo, Nazarian Saman
机构信息
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland; Leviev Heart Center, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel.
Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.
出版信息
J Am Coll Cardiol. 2014;64(20):2111-9. doi: 10.1016/j.jacc.2014.08.039. Epub 2014 Nov 10.
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.
OBJECTIVES
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.
背景
心电图（ECG）上心率校正后的QT间期延长与冠心病患者心肌梗死风险增加及心血管疾病（CVD）相关死亡有关。
目的
本研究旨在探讨无既往已知CVD个体的基线QT间期与心血管事件发生之间的预后关联。
方法
在动脉粥样硬化多族裔研究（MESA）的6273名参与者中，通过对年龄、性别、种族/民族和RR间期进行校正，确定校正后的基线12导联ECG QT间期时长（QTcorr）。使用校正人口统计学和临床风险因素的Cox比例风险模型来研究基线QTcorr与心血管事件发生之间的关联。
结果
入组时的平均年龄为61.7±10岁，53.4%的参与者为女性。在平均8.0±1.7年的随访中，291名参与者发生了心血管事件。校正CVD风险因素和潜在混杂因素后，基线QTcorr每增加10毫秒，与心力衰竭发生（风险比[HR]：1.25；95%CI：1.14至1.37）、CVD事件（HR：1.12；95%CI：1.05至1.20）和中风（HR：1.19；95%CI：1.07至1.32）相关。没有证据表明存在性别或种族的交互作用。
结论
QT间期与无既往CVD的中老年人心血管事件发生相关。
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