Can prolonged P-R interval predict clinical outcomes in non-ST elevation acute coronary syndrome patients?
Mohammad Zareei1, Hossein Zareiamand2, Mahsa Kamali3
1Faculty of Medicine, Sari Branch, Islamic Azad University, Sari, Iran.
Insights
Prolonged P-R interval did not significantly predict clinical outcomes like stroke or death in non-ST elevation acute coronary syndrome patients over six months. Further long-term studies are needed for definitive conclusions on this cardiac marker.
Area of Science:
- Cardiology
- Clinical Medicine
- Diagnostic Markers
Background:
- Assessing predictive value of electrocardiographic findings in acute coronary syndromes is crucial for patient management.
- The P-R interval, reflecting atrioventricular conduction, may offer prognostic information in cardiac conditions.
Purpose of the Study:
- To determine if a prolonged P-R interval can predict clinical outcomes in patients with non-ST elevation acute coronary syndrome (NSTEACS).
Main Methods:
- A descriptive-analytical study included 248 NSTEACS patients, divided into prolonged and normal P-R interval groups.
- Exclusion criteria included specific cardiac conditions and medications; data collected via questionnaire and follow-up.
- Six-month follow-up assessed outcomes such as ischemic stroke, coronary artery disease (CAD), and cardiovascular death.
Main Results:
- Patients with prolonged P-R intervals showed higher frequencies of ischemic stroke, CAD, and cardiovascular death, though these differences were not statistically significant (p > 0.05).
- Multivariate logistic regression found no significant relationship between prolonged P-R interval and adverse outcomes or specific angiographic findings.
- Significant differences were observed between groups in history of myocardial infarction, HDL levels, heart rate, and specific ECG/angiographic findings.
Conclusions:
- A prolonged P-R interval did not significantly predict adverse clinical outcomes within a six-month follow-up period in NSTEACS patients.
- The study suggests that while baseline differences exist, the P-R interval's predictive power for short-term outcomes in this cohort is limited.
- Further research with longer follow-up periods is recommended to fully elucidate the prognostic implications of a prolonged P-R interval in NSTEACS.
Background:
The present study aimed to respond to clinical question, can prolonged P-R interval predict clinical outcomes in non-ST elevation acute coronary syndrome patients?
Methods:
This descriptive-analytical study was conducted on cardiac patients. All of the non-ST elevation acute coronary syndrome (NSTEACS) including non-ST elevation myocardial infarction (NSTEMI) and unstable angina patients included in the study. Then they divided into two groups: prolonged P-R interval and normal P-R interval. The patients who had a history of digoxin and calcium channel blocker use, using antiarrhythmic drugs, known valvular or congenital heart disease and connective tissue, unreadable P-R interval and cardiac block were excluded. Data were collected using the questionnaire consisted demographic data and clinical outcomes and a follow-up part was completed by one of the researchers.
Results:
Finally, 248 patients completed the study. The results showed both of the two groups had significant differences in terms of the history of myocardial infarction (MI) (p = 0.018), the level of high-density lipoprotein (HDL) (p = 0.004), heart rate (p = 0.042), inverted T wave (p = 0.017), anterior ST- segment depression (p = 0.008), normal report of coronary angiography (CAG) (p = 0.003), three vessels disease (p = 0.043), left main lesion (p = 0.045) and SYNTAX score (p = 0.032) based on the CAG report. The results of six-month follow-up showed although, the frequency of ischemic stroke, coronary artery disease (CAD) and cardiovascular death were higher in prolonged P-R interval groups. The chi-square test showed this difference was statistically non-significant (p > 0.05). The multivariate logistic regression model revealed non-significant relationships between prolonged P-R interval and SYNTAX score, significant CAD, three-vessel disease, inverted T wave, anterior ST depression, heart rate and HDL.
Conclusions:
Based on the results of our study the six-month follow-up showed non-significant outcomes. Further studies are recommended to assess the long-term outcomes.
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