Factors associated with development of prolonged QRS duration over 20 years in healthy young adults: The coronary artery risk development in young adults study

Background: Data describing factors associated with the development of a prolonged QRS duration (QRSd) from young adulthood to middle age are sparse. Methods: We analyzed 12-lead electrocardiograms (ECGs) from the Coronary Artery Risk Development in Young Adults study over 20 years. We performed logistic regression to examine the associations of baseline (year 0) or average (years 0-20) risk factors with incident prolonged QRSd (QRS >100 milliseconds). Results: We included 2537 participants (57.2% women, 44.7% black; mean age, 25 years); 292 (11.5%) developed incident QRSd greater than 100 milliseconds by year 20. In univariate analyses, baseline covariates associated with incident QRSd prolongation included white race, male sex, ECG-left ventricular mass index, and baseline QRSd. Similar results were observed after multivariable adjustment. Conclusion: We found no long-term associations of modifiable risk factors with incident QRSd >100 milliseconds. Men, whites, and those with higher ECG-left ventricular mass index and QRSd in young adulthood are at an increased risk for incident prolonged QRSd by middle age.