P4422Increasing QRS width from age 50 to 60 years among randomly selected men associated with higher incidence of cardiovascular disease the following decade

Abstract

Background: Although the QRS complex reflects intra‐ventricular conduction delay and has been shown to be a prognostic marker in coronary artery disease, few studies have investigated the dynamics in QRS duration over time, nor the predictive value of such changes for long‐term cardiovascular disease in the general population. Aim: To study the impact of changes in QRS duration from age 50 to 60 on the risk of cardiovascular disease during a 11‐year follow‐up period. Method: A random population sample of 798 men born in 1943, and living in Gothenburg, Sweden, were initially examined in 1993 at age 50, and re‐examined at age 60 and age 71. Data on medical history, concomitant diseases and general health were collected at each examination. Men who developed cardiovascular disease before the examination at 60 years of age were excluded. ΔQRS was defined as QRS duration at 60 ‐ QRS duration at 50 years. Participants were divided into quartiles according to ΔQRS (Quartile 1: ΔQRS<0ms, Quartile 2: 0ms ≤ ΔQRS <4ms, Quartile 3: 4ms ≤ ΔQRS <12ms, Quartile 4: ΔQRS ≥12ms). The major end‐points were applied in this study was cardiovascular disease. The criteria for defining a cardiovascular disease were the time to first occurrence of myocardial infarction, heart failure, death resulting from coronary heart disease, stroke, intermittent claudication, other cardiovascular death and revascularization procedures. Result: QRS width increased in 3 out of 4 men. Compared with men in quartile 1 (ΔQRS<0ms), men with ΔQRS ≥12ms between 50 and 60 years of age had 71% increased risk of cardiovascular disease from 60 to 71 years of age (HR 1.71, CI1.02‐2.88, P=0.04), compared to men with ΔQRS<0ms when adjusted for BMI, systolic blood pressure smoking, hyperlipidemia, diabetes and heart rate in a multivariable Cox regression analysis. Conclusion: In this sample of men from the general population, an increase in QRS width, during from 50 to 60 years of age predicted cardiovascular disease during a further 11 years of follow‐up. (Figure Presented).