QT interval and long-term mortality risk in the Framingham heart study

Peter Noseworthy, Gina M. Peloso, Shih Jen Hwang, Martin G. Larson, Daniel Levy, Christopher J. O'Donnell, Christopher Newton-Cheh

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: The association between QT interval and mortality has been demonstrated in large, prospective population-based studies, but the strength of the association varies considerably based on the method of heart rate correction. We examined the QT-mortality relationship in the Framingham Heart Study (FHS). Methods: Participants in the first (original cohort, n = 2,365) and second generation (offspring cohort, n = 4,530) cohorts were included in this study with a mean follow up of 27.5 years. QT interval measurements were obtained manually using a reproducible digital caliper technique. Results: Using Cox proportional hazards regression adjusting for age and sex, a 20 millisecond increase in QTc (using Bazett's correction; QT/RR1/2 interval) was associated with a modest increase in risk of all-cause mortality (HR 1.14, 95% CI 1.10-1.18, P < 0.0001), coronary heart disease (CHD) mortality (HR 1.15, 95% CI 1.05-1.26, P = 0.003), and sudden cardiac death (SCD, HR 1.19, 95% CI 1.03-1.37, P = 0.02). However, adjustment for heart rate using RR interval in linear regression attenuated this association. The association of QT interval with all-cause mortality persisted after adjustment for cardiovascular risk factors, but associations with CHD mortality and SCD were no longer significant. Conclusion: In FHS, there is evidence of a graded relation between QTc and all-cause mortality, CHD death, and SCD; however, this association is attenuated by adjustment for RR interval. These data confirm that using Bazett's heart rate correction, QTc, overestimates the association with mortality. An association with all-cause mortality persists despite a more complete adjustment for heart rate and known cardiovascular risk factors.

Original languageEnglish (US)
Pages (from-to)340-348
Number of pages9
JournalAnnals of Noninvasive Electrocardiology
Volume17
Issue number4
DOIs
StatePublished - Oct 1 2012
Externally publishedYes

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Mortality
Heart Rate
Coronary Disease
Sudden Cardiac Death
Linear Models
Population

Keywords

  • heart rate
  • mortality
  • QT interval
  • sudden cardiac death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Noseworthy, P., Peloso, G. M., Hwang, S. J., Larson, M. G., Levy, D., O'Donnell, C. J., & Newton-Cheh, C. (2012). QT interval and long-term mortality risk in the Framingham heart study. Annals of Noninvasive Electrocardiology, 17(4), 340-348. https://doi.org/10.1111/j.1542-474X.2012.00535.x

QT interval and long-term mortality risk in the Framingham heart study. / Noseworthy, Peter; Peloso, Gina M.; Hwang, Shih Jen; Larson, Martin G.; Levy, Daniel; O'Donnell, Christopher J.; Newton-Cheh, Christopher.

In: Annals of Noninvasive Electrocardiology, Vol. 17, No. 4, 01.10.2012, p. 340-348.

Research output: Contribution to journalArticle

Noseworthy, P, Peloso, GM, Hwang, SJ, Larson, MG, Levy, D, O'Donnell, CJ & Newton-Cheh, C 2012, 'QT interval and long-term mortality risk in the Framingham heart study', Annals of Noninvasive Electrocardiology, vol. 17, no. 4, pp. 340-348. https://doi.org/10.1111/j.1542-474X.2012.00535.x
Noseworthy, Peter ; Peloso, Gina M. ; Hwang, Shih Jen ; Larson, Martin G. ; Levy, Daniel ; O'Donnell, Christopher J. ; Newton-Cheh, Christopher. / QT interval and long-term mortality risk in the Framingham heart study. In: Annals of Noninvasive Electrocardiology. 2012 ; Vol. 17, No. 4. pp. 340-348.
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AU - O'Donnell, Christopher J.

AU - Newton-Cheh, Christopher

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