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

Sheila Tatsumi Kimura-Medorima, Ana Paula Beppler Lazaro Lino, Marcel P C Almeida, Marcio J O Figueiredo, Lindemberg da Mota Silveira-Filho, Pedro Paulo Martins de Oliveira, Otavio Rizzi Coelho, José Roberto Matos Souza, Wilson Nadruz, Orlando Petrucci and Andrei C Sposito

PLOS ONE, 2018, vol. 13, issue 7, 1-13

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.

Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0199718

DOI: 10.1371/journal.pone.0199718

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