Open AccessP‐Wave Morphologic Characteristics Predict Cardiovascular Events in a Community‐Dwelling Population
Author(s) -
Kabutoya Tomoyuki,
Ishikawa Shizukiyo,
Ishikawa Joji,
Hoshide Satoshi,
Kario Kazuomi
Publication year - 2012
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/j.1542-474x.2012.00529.x
Subject(s) - medicine , cardiology , left ventricular hypertrophy , odds ratio , confidence interval , population , myocardial infarction , cohort , stroke (engine) , blood pressure , mechanical engineering , environmental health , engineering
Background: There have been few reports on the relationship between P‐wave characteristics and long‐term cardiovascular events. Methods: A nested case‐control study was conducted as part of the Jichi Medical School cohort study, which enrolled 12,490 subjects in a community‐dwelling population. The mean follow‐up period was 10.7 years. The P‐wave characteristics of 526 patients who suffered cardiovascular events (fatal/nonfatal stroke, fatal/nonfatal myocardial infarction, and sudden death) within the follow‐up period (case group) were compared with those of 1578 matched controls (control group). The P‐wave morphology was classified as normal, deflected, and notched type in precordial leads. A broad P wave was defined as a maximum P‐wave duration of more than 120 ms in any of the 12 leads. Results: The mean age was 64 ± 8 years and the percentage of males was 54% in both groups. A notched P wave at baseline was observed in 10.1% of the case group and 6.0% of the control group (P = 0.001). A notched P wave was a significant predictor of cardiovascular events after adjustment for covariates (odds ratio = 1.59; 95% confidence interval = 1.08–2.33). Among the patients with left ventricular hypertrophy as evaluated by the Sokolow–Lyon criteria or Cornell product criteria, there was no significant difference in cardiovascular events between those with and those without a notched P wave, but in the absence of left ventricular hypertrophy, patients with a notched P wave suffered more cardiovascular events than those without a notched P wave by each criteria. Conclusion: P‐wave morphologic characteristics were effective for predicting cardiovascular events.