QT-interval duration and mortality rate results from the third national health and nutrition examination survey

Yiyi Zhang, Wendy S. Post, Darshan Dalal, Elena Blasco-Colmenares, Gordon F. Tomaselli, Eliseo Guallar

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Background: Extreme prolongation or reduction of the QT interval predisposes patients to malignant ventricular arrhythmias and sudden cardiac death, but the association of variations in the QT interval within a reference range with mortality end points in the general population is unclear. Methods: We included 7828 men and women from the Third National Health and Nutrition Examination Survey. Baseline QT interval was measured via standard 12-lead electrocardiographic readings. Mortality end points were assessed through December 31, 2006 (2291 deaths). Results: After an average follow-up of 13.7 years, the association between QT interval and mortality end points was U-shaped. The multivariate-adjusted hazard ratios comparing participants at or above the 95th percentile of age-, sex-, race-, and R-R interval-corrected QT interval (≥439 milliseconds) with participants in the middle quintile (401 to<410 milliseconds) were 2.03 (95% confidence interval, 1.46-2.81) for total mortality, 2.55 (1.59-4.09) for mortality due to cardiovascular disease (CVD), 1.63 (0.96-2.75) for mortality due to coronary heart disease, and 1.65 (1.16-2.35) for non-CVD mortality. The corresponding hazard ratios comparing participants with a corrected QT interval below the fifth percentile (<377 milliseconds)with those in the middle quintile were 1.39 (95% confidence interval, 1.02-1.88) for total mortality, 1.35 (0.77-2.36) for CVD mortality, 1.02 (0.44-2.38) for coronary heart disease mortality, and 1.42 (0.97-2.08) for non-CVD mortality. Increased mortality also was observed with less extreme deviations of QT-interval duration. Similar, albeit weaker, associations also were observed with Bazett-corrected QT intervals. Conclusion: Shortened and prolonged QT-interval durations, even within a reference range, are associated with increased mortality risk in the general population.

Original languageEnglish (US)
Pages (from-to)1727-1733
Number of pages7
JournalArchives of Internal Medicine
Volume171
Issue number19
DOIs
StatePublished - Oct 24 2011
Externally publishedYes

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Nutrition Surveys
Mortality
Coronary Disease
Reference Values
Cardiovascular Diseases
Confidence Intervals
Sudden Cardiac Death
Population
Cardiac Arrhythmias
Reading

ASJC Scopus subject areas

  • Internal Medicine

Cite this

QT-interval duration and mortality rate results from the third national health and nutrition examination survey. / Zhang, Yiyi; Post, Wendy S.; Dalal, Darshan; Blasco-Colmenares, Elena; Tomaselli, Gordon F.; Guallar, Eliseo.

In: Archives of Internal Medicine, Vol. 171, No. 19, 24.10.2011, p. 1727-1733.

Research output: Contribution to journalArticle

Zhang, Yiyi ; Post, Wendy S. ; Dalal, Darshan ; Blasco-Colmenares, Elena ; Tomaselli, Gordon F. ; Guallar, Eliseo. / QT-interval duration and mortality rate results from the third national health and nutrition examination survey. In: Archives of Internal Medicine. 2011 ; Vol. 171, No. 19. pp. 1727-1733.
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abstract = "Background: Extreme prolongation or reduction of the QT interval predisposes patients to malignant ventricular arrhythmias and sudden cardiac death, but the association of variations in the QT interval within a reference range with mortality end points in the general population is unclear. Methods: We included 7828 men and women from the Third National Health and Nutrition Examination Survey. Baseline QT interval was measured via standard 12-lead electrocardiographic readings. Mortality end points were assessed through December 31, 2006 (2291 deaths). Results: After an average follow-up of 13.7 years, the association between QT interval and mortality end points was U-shaped. The multivariate-adjusted hazard ratios comparing participants at or above the 95th percentile of age-, sex-, race-, and R-R interval-corrected QT interval (≥439 milliseconds) with participants in the middle quintile (401 to<410 milliseconds) were 2.03 (95{\%} confidence interval, 1.46-2.81) for total mortality, 2.55 (1.59-4.09) for mortality due to cardiovascular disease (CVD), 1.63 (0.96-2.75) for mortality due to coronary heart disease, and 1.65 (1.16-2.35) for non-CVD mortality. The corresponding hazard ratios comparing participants with a corrected QT interval below the fifth percentile (<377 milliseconds)with those in the middle quintile were 1.39 (95{\%} confidence interval, 1.02-1.88) for total mortality, 1.35 (0.77-2.36) for CVD mortality, 1.02 (0.44-2.38) for coronary heart disease mortality, and 1.42 (0.97-2.08) for non-CVD mortality. Increased mortality also was observed with less extreme deviations of QT-interval duration. Similar, albeit weaker, associations also were observed with Bazett-corrected QT intervals. Conclusion: Shortened and prolonged QT-interval durations, even within a reference range, are associated with increased mortality risk in the general population.",
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