The QT interval and risk of incident atrial fibrillation

被引：79

作者：

Mandyam, Mala C. ^{[1
]}

Soliman, Elsayed Z. ^{[2
]}

Alonso, Alvaro ^{[3
]}

Dewland, Thomas A. ^{[1
]}

Heckbert, Susan R. ^{[4
]}

Vittinghoff, Eric ^{[5
]}

Cummings, Steven R. ^{[6
]}

Ellinor, Patrick T. ^{[7
]}

Chaitman, Bernard R. ^{[8
]}

Stocke, Karen ^{[9
]}

Applegate, William B. ^{[10
]}

Arking, Dan E. ^{[11
]}

Butler, Javed ^{[12
]}

Loehr, Laura R. ^{[13
]}

Magnani, Jared W. ^{[14
]}

Murphy, Rachel A. ^{[15
]}

Satterfield, Suzanne ^{[16
]}

Newman, Anne B. ^{[17
]}

Marcus, Gregory M. ^{[1
]}

机构：

[1] Univ Calif San Francisco, Div Cardiol, Electrophysiol Sect, San Francisco, CA 94143 USA

[2] Wake Forest Univ, Sch Med, Epidemiol Cardiol Res Ctr, Dept Epidemiol & Prevent, Winston Salem, NC 27109 USA

[3] Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA

[4] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA

[5] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA

[6] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA

[7] Massachusetts Gen Hosp, Cardiovasc Res Ctr, Charlestown, MA USA

[8] St Louis Univ, Sch Med, ECG Core Lab, St Louis, MO USA

[9] St Louis Univ, Sch Med, ECG Core Lab, St Louis, MO USA

[10] Wake Forest Univ, Sch Med, Div Gerontol & Geriatr Med, Winston Salem, NC 27109 USA

[11] Johns Hopkins Sch Med, McKusick Nathans Inst Genet Med, Baltimore, MD USA

[12] Emory Univ, Dept Med, Div Cardiol, Atlanta, GA 30322 USA

[13] Univ N Carolina, Dept Epidemiol, Chapel Hill, NC USA

[14] Boston Univ, Cardiovasc Med Sect, Dept Med, Boston, MA 02215 USA

[15] Natl Inst Aging, Intramural Res Program, Lab Populat Sci, Bethesda, MD USA

[16] Univ Tennessee, Ctr Hlth Sci, Dept Prevent Med, Memphis, TN 38163 USA

[17] Univ Pittsburgh, Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15260 USA

来源：

HEART RHYTHM | 2013年 / 10卷 / 10期

基金：

美国国家卫生研究院;

关键词：

Atrial fibrillation; Epidemiology; Risk; QT interval; Electrocardiogram; ECG; CARDIOVASCULAR HEALTH; REFRACTORY PERIOD; DELAYED AFTERDEPOLARIZATIONS; ATHEROSCLEROSIS RISK; ASSOCIATION; HEART; PREVALENCE; ECG; CONTRIBUTES; ARRHYTHMIAS;

D O I：

10.1016/j.hrthm.2013.07.023

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Abnormal atrial repolarization is important in the development of atrial fibrillation (AF), but no direct measurement is available in clinical medicine. OBJECTIVE To determine whether the QT interval, a marker of ventricular repolarization, could be used to predict incident AF. METHODS We examined a prolonged QT interval corrected by using the Framingham formula (QTFram) as a predictor of incident AF in the Atherosclerosis Risk in Communities (ARIC) study. The Cardiovascular Health Study (CHS) and Health, Aging, and Body Composition (ABC) study were used for validation. Secondary predictors included QT duration as a continuous variable, a short QT interval, and QT intervals corrected by using other formulas. RESULTS Among 14,538 ARIC study participants, a prolonged QTFram predicted a roughly 2-fold increased risk of AF (hazard ratio [HR] 2.05; 95% confidence interval [CI] 1.42-2.96; P < .001). No substantive attenuation was observed after adjustment for age, race, sex, study center, body mass index, hypertension, diabetes, coronary disease, and heart failure. The findings were validated in Cardiovascular Health Study and Health, Aging, and Body Composition study and were similar across various QT correction methods. Also in the ARIC study, each 10-ms increase in QTFram was associated with an increased unadjusted (HR 1.14; 95% CI 1.10-1.17; P < .001) and adjusted (HR 1.11; 95% CI 1.07-1.14; P < .001) risk of AF. Findings regarding a short QT interval were inconsistent across cohorts. CONCLUSION A prolonged QT interval is associated with an increased risk of incident AF.

引用

页码：1562 / 1568

页数：7

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