Dekker J M, Schouten E G, Klootwijk P, Pool J, Kromhout D
Department of Epidemiology and Public Health, Agricultural University Wageningen, The Netherlands.
Circulation. 1994 Aug;90(2):779-85. doi: 10.1161/01.cir.90.2.779.
Heart-rate-adjusted QT-interval (QTc) is prognostic of sudden death in myocardial infarction patients. So far, population studies have yielded conflicting results on the predictive value of QTc for coronary heart disease morbidity and mortality. Therefore, we investigated this in a longitudinal study of middle-aged and elderly men.
From 1960 to 1985, 877 middle-aged men were followed and repeatedly examined in the Zutphen Study. In 1985 the remaining cohort was extended to 835 elderly men from the same birth cohort and followed until 1990. Men with prolonged QTc (420 ms1/2 or more) had a higher risk of myocardial infarction and coronary heart disease death relative to men with QTc less than 385 ms1/2. Age-adjusted coronary heart disease mortality rate ratios were 4.3 (95% confidence interval, 1.3 to 13.8) in middle-aged men and 3.3 (95% confidence interval, 1.0 to 11.6) in elderly men. These associations could not be attributed to prevalent heart disease and were independent of other cardiovascular risk factors.
These results indicate that within the normal range of QTc in the general population, men with long QTc are at higher risk for coronary heart disease. Because QTc is easily determined, it may provide a valuable contribution to risk stratification.
心率校正的QT间期（QTc）可预测心肌梗死患者的猝死风险。到目前为止，关于QTc对冠心病发病率和死亡率的预测价值，人群研究得出了相互矛盾的结果。因此，我们在一项针对中老年男性的纵向研究中对此进行了调查。
在祖特芬研究中，从1960年至1985年，对877名中年男性进行了随访并反复检查。1985年，剩余队列扩展至来自同一年龄队列的835名老年男性，并随访至1990年。与QTc小于385毫秒1/2的男性相比，QTc延长（420毫秒1/2或更长）的男性发生心肌梗死和冠心病死亡的风险更高。在中年男性中，年龄校正后的冠心病死亡率比值为4.3（95%置信区间，1.3至13.8），在老年男性中为3.3（95%置信区间，1.0至11.6）。这些关联不能归因于现患心脏病，且独立于其他心血管危险因素。
这些结果表明，在一般人群QTc的正常范围内，QTc延长的男性患冠心病的风险更高。由于QTc易于测定，它可能对风险分层有重要价值。
