Abstract 10135: P Wave Duration is Associated with All-cause Mortality: the National Health and Nutrition Epidemiology Survey
Introduction: P wave indices (PWI) are an intermediate phenotype modulated by atrial electrophysiology and morphology. The clinical correlates and association of PWI with all-cause mortality have received limited scrutiny.
Methods: The National Health and Nutrition Examination Survey (NHANES) III quantified PR interval and P wave duration and amplitude. Mortality data were obtained from National Death Index records.
Results: Of 8,561 NHANES subjects with ECGs, 7,713 (mean age 59.9 ± 13.4, 51.9% women, 50.1% ethnic minorities) had ECGs in sinus rhythm, complete covariates and linked mortality data. Over 8.6 years median follow-up (range 0.1–12.2 years), there were 1559 deaths. Mean PR interval and P wave duration were higher with advancing age and were greater in men than women; the reverse was seen for P wave amplitude. Persons of older age, male sex, and with higher BMI had significantly higher PR interval and P wave duration and lower P wave amplitude. African-Americans had higher mean values of all three PWI. In unadjusted analysis, there was progressively higher mortality by P wave duration quartiles (figure 1). In a multivariable model adjusting for cardiovascular risk factors, P wave duration was the only P wave index significantly associated with mortality (HR 1.06, 95% CI 1.00–1.13, p=0.03), demonstrated by figure 2 showing the increase in HR with each change in SD.
Conclusions: In a highly representative U.S. sample, P wave duration was significantly associated with increased mortality and conveyed greater hazard for all-cause mortality than the PR interval. P wave duration may reflect subclinical disease and merits further study as a marker of risk for adverse outcomes.
- © 2010 by American Heart Association, Inc.