Cairo
Oh, I almost forgot. I sat down yesterday night and played a little bit with Cairo. It does have quite a nice API. A full example is at http://vortex.bd.psu.edu/~mkr137/qcairo.tar.bz2 . It's a pure Qt application. You don't need KDE to compile it. It shows how to use Cairo API natively from a QWidget:: paintEvent (you may need to adjust the library paths in the qcairo.pro file).