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(Stroke. 1999;30:1566-1571.)
© 1999 American Heart Association, Inc.

Original Contributions

Is QT Interval a Marker of Subclinical Atherosclerosis in Nondiabetic Subjects?

The Insulin Resistance Atherosclerosis Study (IRAS)

Andreas Festa, MD; Ralph D'Agostino, Jr, PhD; Pentti Rautaharju, MD, PhD; Daniel H. O'Leary, MD; Marian Rewers, MD, PhD; Leena Mykkänen, MD, PhD Steven M. Haffner, MD

From the Department of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio (A.F., L.M., S.M.H.); the Department of Public Health Sciences, Wake Forest University School of Medicine (R.D.), and EPICARE Center (P.R.), Winston-Salem, NC; the Department of Radiology, Tufts University School of Medicine, Boston, Mass (D.H.O.); and the Department of Preventive Medicine and Biometrics, University of Colorado Medical School, Denver, Colo (M.R.).

Correspondence to Andreas Festa, MD, Department of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78284-7873. E-mail festa{at}uthscsa.edu

Background and Purpose—We studied the relationship of heart rate–corrected QT interval with subclinical atherosclerosis, as determined by ultrasonographic measurement of carotid intima-media thickness (IMT) in nondiabetic subjects in the Insulin Resistance Atherosclerosis Study (IRAS). Prolonged heart rate–corrected QT interval is an unfavorable prognostic factor of cardiovascular morbidity and mortality, and QT interval prolongation may be the result of atherosclerosis.

Methods—B-mode ultrasound imaging of the carotid artery IMT was performed in a large, triethnic, nondiabetic population free of clinical coronary artery disease (n=912). QT interval was measured on resting electrocardiograms with use of a computer program and corrected for heart rate with standard equations.

Results—IMT of the common carotid artery correlated significantly with heart rate–corrected QT interval duration (r=0.15 for QT₆₀ and r=0.14 for QTc), whereas no relationship between IMT of the internal carotid artery and QT interval was found (r=-0.01). The association was somewhat stronger in women than in men. In a multiple regression analysis adjusting for demographic variables, the association of common carotid artery IMT to heart rate–corrected QT interval remained highly significant, but adjustment for cardiovascular risk factors weakened the relationship.

Conclusions—We found a significant relation of heart rate–corrected QT interval to carotid atherosclerosis in nondiabetic subjects that was stronger in women and partly mediated by cardiovascular risk factors, including hypertension. QT interval may therefore serve as a marker for clinically undetected ("subclinical") atherosclerotic disease.

Key Words: atherosclerosis • carotid arteries • electrocardiography

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