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Prognostic Value of Frontal QRS-T Angle in Patients Without Clinical Evidence of Cardiovascular Disease (from the Multi-Ethnic Study of Atherosclerosis)

The American journal of cardiology, 2013-12, Vol.112 (12), p.1880-1884 [Peer Reviewed Journal]

Elsevier Inc. ;2013 Elsevier Inc. ;Copyright © 2013 Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Dec 15, 2013 ;2013 Excerpta Medica, Inc. All rights reserved. 2013 ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2013.08.017 ;PMID: 24063831 ;CODEN: AJCDAG

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Title:
Prognostic Value of Frontal QRS-T Angle in Patients Without Clinical Evidence of Cardiovascular Disease (from the Multi-Ethnic Study of Atherosclerosis)
Author: Walsh, Joseph A., MD, MS ; Soliman, Elsayed Z., MD, PhD ; Ilkhanoff, Leonard, MD, MS ; Ning, Hongyan, MD, MS ; Liu, Kiang, PhD ; Nazarian, Saman, MD ; Lloyd-Jones, Donald M., MD, ScM
Subjects: Age ; Aged ; Aged, 80 and over ; Asymptomatic Diseases - epidemiology ; Atherosclerosis ; Body mass index ; Cardiac arrhythmia ; Cardiovascular ; Cardiovascular disease ; Cohort Studies ; Confidence intervals ; Coronary Artery Disease - ethnology ; Coronary Artery Disease - physiopathology ; Electrocardiography ; Female ; Gender ; Heart attacks ; Heart Conduction System - physiopathology ; Heart failure ; Heart rate ; Hospitalization ; Humans ; Male ; Middle Aged ; Mortality ; Prognosis ; Proportional Hazards Models ; Risk Assessment ; Studies ; Triglycerides ; United States - epidemiology ; Veins & arteries
Is Part Of: The American journal of cardiology, 2013-12, Vol.112 (12), p.1880-1884
Description: Abnormal frontal QRS-T angle on a 12-lead electrocardiogram is associated with incident coronary heart disease and total mortality in a biracial cohort, but there have been no studies to date examining QRS-T angle's prognostic value across multiple ethnicities. We studied 6,814 participants (52.7% women, mean age 62 years) from Multi-Ethnic Study of Atherosclerosis, a multiethnic cohort aged 45 to 84 years free of clinical cardiovascular disease (CVD) at enrollment. Baseline examination included measurement of traditional risk factors and 12-lead electrocardiograms. Frontal QRS-T axis was defined as normal (less than seventy-fifth percentile), borderline (seventy-fifth to ninety-fifth percentile), or abnormal (ninety-fifth percentile or more), and participants were followed for the composite end point of incident CVD events: cardiovascular death, myocardial infarction, angina pectoris, or heart failure. After 7.6 years of follow-up, there were 444 total events. Borderline (HR [hazard ratio] 1.37, 95% confidence interval [CI] 1.10 to 1.70) and abnormal QRS-T angles (HR 2.2, 95% CI 1.63 to 2.97) were associated with incident CVD events in multivariate-adjusted models. However, after adjusting for T-wave abnormalities, there was no statistically significant association of either borderline (HR 1.12, 95% CI 0.90 to 1.41) or abnormal (HR 1.31, 95% CI 0.93 to 1.84) QRS-T angle with incident CVD events. Abnormal frontal QRS-T angle predicts incident CVD events in a multiethnic population, and this increased risk is primarily mediated through T-wave abnormalities. QRS-T angle provides an easily interpretable continuous marker of abnormal ventricular repolarization that can aid the everyday clinician in risk prediction.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0002-9149
EISSN: 1879-1913
DOI: 10.1016/j.amjcard.2013.08.017
PMID: 24063831
CODEN: AJCDAG
Source: AUTh Library subscriptions: ProQuest Central
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Prognostic Value of Frontal QRS-T Angle in Patients Without Clinical Evidence of Cardiovascular Disease (from the Multi-Ethnic Study of Atherosclerosis)

Elsevier Inc. ;2013 Elsevier Inc. ;Copyright © 2013 Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Dec 15, 2013 ;2013 Excerpta Medica, Inc. All rights reserved. 2013 ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2013.08.017 ;PMID: 24063831 ;CODEN: AJCDAG

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