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Prognostic significance of P-wave morphology in patients with coronary artery disease

Santeri Nortamo1, Idamaria Laitinen1, Jussi Passi1

  • 1Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.

Journal of Cardiovascular Electrophysiology
|July 17, 2019
PubMed

Insights

P-wave morphology parameters like P-wave residuum and duration independently predict sudden cardiac arrest (SCA) in coronary artery disease (CAD) patients. These findings improve risk prediction models for SCA in this population.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Predictive Medicine

Background:

  • The prognostic value of P-wave morphology in coronary artery disease (CAD) patients remains unclear.
  • Sudden cardiac arrest (SCA) is a significant concern in patients with CAD.

Purpose of the Study:

  • To investigate the prognostic significance of P-wave morphology in predicting SCA in patients with CAD.
  • To determine if P-wave parameters can improve existing risk prediction models for SCA.

Main Methods:

  • Analysis of P-wave morphology in 1797 patients with angiographically verified CAD from the ARTEMIS study.
  • Univariate and multivariate analyses were performed to assess the association between P-wave parameters (PWR, PWH, Pdur) and outcomes like SCA.
  • P-wave parameters were added to a clinical risk model to evaluate improvements in discrimination and reclassification accuracy.

Main Results:

  • Absolute P-wave residuum (PWR), P-wave heterogeneity (PWH), and P-wave duration (Pdur) were significantly associated with the risk of SCA.
  • These parameters remained independent predictors of SCA even after adjusting for traditional risk factors.
  • Incorporating P-wave parameters into a clinical risk model significantly improved its discrimination and reclassification accuracy, increasing the C-index from 0.745 to 0.787.

Conclusions:

  • P-wave morphology parameters independently predict SCA in patients with CAD.
  • These ECG findings offer valuable prognostic information beyond traditional risk factors.
  • P-wave analysis can enhance the accuracy of SCA risk stratification in CAD patients.
Abstract

Keywords:
P-waveP-wave morphologyelectrocardiogramsudden cardiac death

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