Int J Arrhythm.  2020 Dec;21(4):16. 10.1186/s42444-020-00024-6.

Baseline Framingham risk score does not predict future ECG‑derived QRS duration over an average of 3.3 years

  • 1Rural Clinical School, University of New South Wales, Sydney, Australia.
  • 2Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China
  • 3The School of Economics, Xiamen University, Xiamen, China.
  • 4Health Sciences, Charles Sturt University, Albury, VIC, Australia.
  • 5Centre for Healthy Futures, Health Faculty, Torrens University Australia, Pyrmont Campus, Sydney, 5/235 Pyrmont St, Pyrmont, NSW 2009, Australia.


Prolonged electrocardiogram (ECG) QRS duration has been associated with increased cardiovascular risk. It is unclear whether the main predictor of cardiovascular risk, the Framingham risk score also predicts short-term changes in ECG QRS duration. Our aim is to determine whether baseline Framingham risk score is associated with baseline or changes in QRS duration.
A retrospective cross-sectional analysis was performed using observational data obtained from two hundred two participants. Framingham risk score was calculated using an online risk calculator. QRS duration was obtained using a 10 s trace from a Welch Allyn PC-based 12-lead ECG system.
Average follow-up duration was 3.3 ± 1.1 years. Mean QRS change was 1.8 ± 11.4 ms. Specifically, among two hundred two participants, there are 104 subjects with a greater QRS duration at follow-up, while 98 subjects had the same or a shorter follow-up QRS duration. Baseline Framingham risk score did not significantly predict an increase in QRSd with an odds ratio of 1.04 (P = 0.230). Regression analysis of QRS duration at baseline and Framingham risk at baseline had a weak association (R2 = 0.020;P = 0.043). The Framingham risk score at follow-up was likewise has a weak association with follow-up QRS duration (R2 = 0.045; P = 0.002).
Our results do not demonstrate a statistically significant association between Framingham risk parameters and future QRS duration changes over longitudinal time. QRS duration had variable changes between baseline and follow-up. This might suggest that a longer period of follow-up is required to document more stable increases in QRS duration associated with ventricular pathology. A larger population study is needed to confirm our observations.


ECG; QRS duration; Framingham risk score; Population study; Rural
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