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QRS Interval Fails to Predict Coronary Disease Incidence: The Framingham Study

QRS Interval Fails to Predict Coronary Disease Incidence: The Framingham Study Abstract The Framingham Study cohort of 5209 white men and women was examined to determine the long-term incidence of manifestations of new coronary heart disease as a function of QRS interval on subjects' baseline electrocardiograms (recorded at the 9th biennial examination). Over 18 years of follow-up, age-adjusted incidence of myocardial infarction, angina pectoris, and coronary death appeared unrelated to baseline QRS prolongation in both sexes, by Cox regression. Subjects with left bundlebranch block fared no worse than those with right pattern. These relations held whether or not subjects with baseline electrocardiographic abnormalities other than intraventricular block were excluded from consideration. In sum, QRS duration is an unimportant predictor of coronary disease in this Framingham population. (Arch Intern Med. 1991;151:1365-1368) References 1. Schneider JF, Thomas HE Jr, Kreger BE, McNamara PM, Kannel WB. Newly acquired left bundle-branch block: the Framingham Study . Ann Intern Med. 1979;90:303-310.Crossref 2. Schneider JF, Thomas HE Jr, Kreger BE, Sorlie P, Kannel WB. Newly acquired right bundle-branch block: the Framingham Study . Ann Intern Med. 1980;92:37-44.Crossref 3. Schneider JF, Thomas HE Jr, Sorlie P, Kreger BE, McNamara PM, Kannel WB. Comparative features of newly acquired left and right bundle branch block in the general population: the Framingham Study . Am J Cardiol. 1981;47:931-940.Crossref 4. Kreger BE, Kannel WB, Cupples LA. Electrocardiographic precursors of sudden unexpected death: the Framingham Study . Circulation. 1987;75 ( (suppl 2) ):1122-1124. 5. Kreger BE, Cupples LA, Kannel WB. The electrocardiogram in prediction of sudden death: Framingham Study experience . Am Heart J. 1987;113:377-382.Crossref 6. Kreger BE, Anderson KM, Kannel WB. Prevalence of intraventricular block in the general population: the Framingham Study . Am Heart J. 1989;117:903-910.Crossref 7. Dawber TR, Meadors GF, Moore FE Jr. Epidemiological approaches to heart disease: the Framingham Study . Am J Public Health. 1951;41:279-286.Crossref 8. Gordon T, Moore FE Jr, Shurtleff D, Dawber TR. Some methodologic problems in the long-term study of cardiovascular disease: observations on the Framingham Study . J Chronic Dis. 1959;10:186-206.Crossref 9. Cupples LA, D'Agostino RB. Section 34: some risk factors related to the annual incidence of cardiovascular disease and death using pooled repeated biennial measurements: Framingham Heart Study, 30-year followup. In: Kannel WB, Wolf PA, Garrison RJ, eds. The Framingham Study: An Epidemiological Investigation of Cardiovascular Disease. Washington, DC: US Government Printing Office; 1987. Dept of Health and Human Services publication NIH 87-2703. 10. Cox DR. Regression models and life tables . J R Stat Soc. 1972;34:187-220. 11. Sugiura T, Iwasaka T, Hasegawa T, et al. Factors associated with persistent and transient fascicular blocks in anterior wall acute myocardial infarction . Am J Cardiol. 1989;63:784-787.Crossref 12. Sclarovsky S, Sagie A, Strasberg B, et al. Ischemic blocks during early phase of anterior myocardial infarction: correlation with ST-segment shift . Clin Cardiol. 1988;11:757-762.Crossref 13. Dubois C, Pierard LA, Smeets JP, Foidart G, Legrand V, Kulbertus HE. Short- and long-term prognostic importance of complete bundle-branch block complicating acute myocardial infarction . Clin Cardiol. 1988;11:292-296.Crossref 14. Caspi Y, Safadi T, Ammar R, Elamy A, Fishman NH, Merin G. The significance of bundle branch block in the immediate postoperative electrocardiograms of patients undergoing coronary artery bypass . J Thorac Cardiovasc Surg. 1987;93:442-446. 15. Wexelman W, Lichstein E, Cunningham JN, Hollander G, Greengart A, Shani J. Etiology and clinical significance of new fascicular conduction defects following coronary bypass surgery . Am Heart J. 1986;111:923-927.Crossref 16. Williams MA, Esterbrooks DJ, Nair CK, Sailors MM, Sketch MH. Clinical significance of exercise-induced bundle branch block . Am J Cardiol. 1988;61:346-348.Crossref 17. Singer RB. Mortality in 966 life insurance applicants with bundle branch block or wide QRS . Trans Assoc Life Insur Med Dir Am. 1968;52:94-114. 18. Canaveris G, Halpern MS. Intraventricular conduction disturbances in flying personnel: incomplete right bundle branch block . Aviat Space Environ Med. 1988;59:960-964. 19. Canaveris G. Intraventricular conduction disturbances in flying personnel: right bundle branch block . Aviat Space Environ Med. 1986;57:591-596. 20. Liao YL, Emidy LA, Dyer A, et al. Characteristics and prognosis of incomplete right bundle branch block: an epidemiologic study . J Am Coll Cardiol. 1986;7:492-499.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

QRS Interval Fails to Predict Coronary Disease Incidence: The Framingham Study

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400070127016
Publisher site
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Abstract

Abstract The Framingham Study cohort of 5209 white men and women was examined to determine the long-term incidence of manifestations of new coronary heart disease as a function of QRS interval on subjects' baseline electrocardiograms (recorded at the 9th biennial examination). Over 18 years of follow-up, age-adjusted incidence of myocardial infarction, angina pectoris, and coronary death appeared unrelated to baseline QRS prolongation in both sexes, by Cox regression. Subjects with left bundlebranch block fared no worse than those with right pattern. These relations held whether or not subjects with baseline electrocardiographic abnormalities other than intraventricular block were excluded from consideration. In sum, QRS duration is an unimportant predictor of coronary disease in this Framingham population. (Arch Intern Med. 1991;151:1365-1368) References 1. Schneider JF, Thomas HE Jr, Kreger BE, McNamara PM, Kannel WB. Newly acquired left bundle-branch block: the Framingham Study . Ann Intern Med. 1979;90:303-310.Crossref 2. Schneider JF, Thomas HE Jr, Kreger BE, Sorlie P, Kannel WB. Newly acquired right bundle-branch block: the Framingham Study . Ann Intern Med. 1980;92:37-44.Crossref 3. Schneider JF, Thomas HE Jr, Sorlie P, Kreger BE, McNamara PM, Kannel WB. Comparative features of newly acquired left and right bundle branch block in the general population: the Framingham Study . Am J Cardiol. 1981;47:931-940.Crossref 4. Kreger BE, Kannel WB, Cupples LA. Electrocardiographic precursors of sudden unexpected death: the Framingham Study . Circulation. 1987;75 ( (suppl 2) ):1122-1124. 5. Kreger BE, Cupples LA, Kannel WB. The electrocardiogram in prediction of sudden death: Framingham Study experience . Am Heart J. 1987;113:377-382.Crossref 6. Kreger BE, Anderson KM, Kannel WB. Prevalence of intraventricular block in the general population: the Framingham Study . Am Heart J. 1989;117:903-910.Crossref 7. Dawber TR, Meadors GF, Moore FE Jr. Epidemiological approaches to heart disease: the Framingham Study . Am J Public Health. 1951;41:279-286.Crossref 8. Gordon T, Moore FE Jr, Shurtleff D, Dawber TR. Some methodologic problems in the long-term study of cardiovascular disease: observations on the Framingham Study . J Chronic Dis. 1959;10:186-206.Crossref 9. Cupples LA, D'Agostino RB. Section 34: some risk factors related to the annual incidence of cardiovascular disease and death using pooled repeated biennial measurements: Framingham Heart Study, 30-year followup. In: Kannel WB, Wolf PA, Garrison RJ, eds. The Framingham Study: An Epidemiological Investigation of Cardiovascular Disease. Washington, DC: US Government Printing Office; 1987. Dept of Health and Human Services publication NIH 87-2703. 10. Cox DR. Regression models and life tables . J R Stat Soc. 1972;34:187-220. 11. Sugiura T, Iwasaka T, Hasegawa T, et al. Factors associated with persistent and transient fascicular blocks in anterior wall acute myocardial infarction . Am J Cardiol. 1989;63:784-787.Crossref 12. Sclarovsky S, Sagie A, Strasberg B, et al. Ischemic blocks during early phase of anterior myocardial infarction: correlation with ST-segment shift . Clin Cardiol. 1988;11:757-762.Crossref 13. Dubois C, Pierard LA, Smeets JP, Foidart G, Legrand V, Kulbertus HE. Short- and long-term prognostic importance of complete bundle-branch block complicating acute myocardial infarction . Clin Cardiol. 1988;11:292-296.Crossref 14. Caspi Y, Safadi T, Ammar R, Elamy A, Fishman NH, Merin G. The significance of bundle branch block in the immediate postoperative electrocardiograms of patients undergoing coronary artery bypass . J Thorac Cardiovasc Surg. 1987;93:442-446. 15. Wexelman W, Lichstein E, Cunningham JN, Hollander G, Greengart A, Shani J. Etiology and clinical significance of new fascicular conduction defects following coronary bypass surgery . Am Heart J. 1986;111:923-927.Crossref 16. Williams MA, Esterbrooks DJ, Nair CK, Sailors MM, Sketch MH. Clinical significance of exercise-induced bundle branch block . Am J Cardiol. 1988;61:346-348.Crossref 17. Singer RB. Mortality in 966 life insurance applicants with bundle branch block or wide QRS . Trans Assoc Life Insur Med Dir Am. 1968;52:94-114. 18. Canaveris G, Halpern MS. Intraventricular conduction disturbances in flying personnel: incomplete right bundle branch block . Aviat Space Environ Med. 1988;59:960-964. 19. Canaveris G. Intraventricular conduction disturbances in flying personnel: right bundle branch block . Aviat Space Environ Med. 1986;57:591-596. 20. Liao YL, Emidy LA, Dyer A, et al. Characteristics and prognosis of incomplete right bundle branch block: an epidemiologic study . J Am Coll Cardiol. 1986;7:492-499.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1991

References