BackgroundHeart-rate-adjusted QT-interval (QTc) is prognostic of sudden death in myocardial infarction patients. So far, population studies have yielded conflicting results on the predictive value of QTcfor coronary heart disease morbidity and mortality. Therefore, we investigated this in a longitudinal study of middle-aged and elderly men.Methods and ResultsFrom 1960 to 1985, 877 middle-aged men were followed and repeatedly examined in the Zutphen Study. In 1985 the remaining cohort was extended to 835 elderly men from the same birth cohort and followed until 1990. Men with prolonged QTc(420 ms1/2or more) had a higher risk of myocardial infarction and coronary heart disease death relative to men with QTcless than 385 ms1/2. Ageadjusted coronary heart disease mortality rate ratios were 4.3 (95% confidence interval, 1.3 to 13.8) in middle-aged men and 3.3 (95% confidence interval, 1.0 to 11.6) in elderly men. These associations could not be attributed to prevalent heart disease and were independent of other cardiovascular risk factors.ConclusionsThese results indicate that within the normal range of QTcin the general population, men with long QTcare at higher risk for coronary heart disease. Because QTcis easily determined, it may provide a valuable contribution to risk stratification.