P-wave duration is a predictor for long-term mortality in post-CABG patients

PLoS One. 2018 Jul 11;13(7):e0199718. doi: 10.1371/journal.pone.0199718. eCollection 2018.

Abstract

Risk stratification in secondary prevention has emerged as an unmet clinical need in order to mitigate the Number-Needed-to-Treat and make expensive therapies both clinically relevant and cost-effective. P wave indices reflect atrial conduction, which is a sensitive marker for inflammatory, metabolic, and pressure overload myocardial cell remodeling; the three stimuli are traditional mechanisms for adverse clinical evolution. Accordingly, we sought to investigate the predictive role of P-wave indices to estimate residual risk in patients with chronic coronary artery disease (CAD). The cohort included 520 post-Coronary Artery Bypass Grafting patients with a median age of 60 years who were followed for a median period of 1025 days. The primary endpoint was long-term all-cause death. Cubic spline model demonstrated a linear association between P-wave duration and incidence rate of long-term all-cause death (p = 0.023). P-wave >110ms was a marker for an average of 425 days shorter survival as compared with P-wave under 80ms (Logrank p = 0.020). The Cox stepwise regression models retained P-wave duration as independent marker (HR:1.37; 95%CI:1.05-1.79,p = 0.023). In conclusion, the present study suggests that P-wave measurement may constitute a simple, inexpensive and accessible prognostic tool to be added in the bedside risk estimation in CAD patients.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / surgery
  • Electrocardiography
  • Female
  • Heart Rate*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / mortality

Grants and funding

The authors received no specific funding for this work.