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

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, metaboli...

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Bibliographic Details
Published in:PloS one 2018-07, Vol.13 (7), p.e0199718-e0199718
Main Authors: Kimura-Medorima, Sheila Tatsumi, Lino, Ana Paula Beppler Lazaro, Almeida, Marcel P C, Figueiredo, Marcio J O, Silveira-Filho, Lindemberg da Mota, de Oliveira, Pedro Paulo Martins, Coelho, Otavio Rizzi, Souza, José Roberto Matos, Nadruz, Jr, Wilson, Petrucci, Jr, Orlando, Sposito, Andrei C
Format: Article
Language:English
Subjects:
Aged
Biology and Life Sciences
Cardiac arrhythmia
Cardiology
Cardiovascular disease
Care and treatment
Conduction
Coronary artery
Coronary artery bypass
Coronary Artery Bypass - adverse effects
Coronary artery disease
Coronary Artery Disease - epidemiology
Coronary Artery Disease - mortality
Coronary Artery Disease - physiopathology
Coronary Artery Disease - surgery
Coronary heart disease
Coronary vessels
Diabetes
Electrocardiography
Female
Forecasts and trends
Health aspects
Heart diseases
Heart failure
Heart Rate
Humans
Inflammation
Male
Medicine and Health Sciences
Methods
Middle Aged
Mortality
P waves
Patient outcomes
Patients
Physical Sciences
Postoperative Complications - epidemiology
Postoperative Complications - mortality
Prevention
Quality of life
Regression analysis
Regression models
Research and Analysis Methods
Risk
Surgery
Wave measurement
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Summary: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.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0199718