Abstract 12880: J-Shaped Association between P-Wave Duration and Risk of Atrial Fibrillation: Results from The Copenhagen ECG Study
Introduction Atrial fibrillation (AF) is a serious and growing health care burden worldwide. Prior studies have shown a linear association between ECG P-wave duration and the risk of AF. Results from recent genome wide association studies of the related PR-interval, however, indicate a possible J-shaped association. We aimed to investigate this in the hitherto largest population based study.
Methods We included about one third of the population (n=326,959) in the region of Copenhagen, Denmark. Since 2001 these individuals had one or more electrocardiograms recorded and stored digitally in a general practitioner core facility. All ECG analyses were performed using computer algorithms. Data on the outcome (AF) as well as on known risk factors for this was taken from Danish registers allowing for almost complete follow-up. A Cox proportional hazard model was used. The model was adjusted for PR-interval, age, gender, hypertension, prior myocardial infarction MI), congestive heart failure (CHF), valve disease, diabetes, and thyroid disease. P-wave duration was analyzed in deciles.
Results Median age was 54 (SD 17) years, 45% were male, 15% had hypertension, 5% had diabetes, 0.7% had CHF and 7% had prior MI. Median follow-up was 5.08 (IQR 2.56-7.67) years corresponding to 1.432.334 person-years, and 9.451 developed AF during follow-up. The result from the Cox model showed a J-shaped association between P-wave duration in deciles and the risk of AF (Figure). Being in the 3rd decile (98-102 ms) conferred the lowest risk and the hazard ratio (HR) for being in the lowest (124 ms) vs. the 3rd decile was 1.93 (95% CI 1.75-2.12).
Conclusions In this large primary care population we found a J-shaped association between P-wave duration and the risk of incident AF. This finding may have impact on AF risk models and on theories of AF pathophysiology.
- © 2012 by American Heart Association, Inc.