Abstract MP055: T- Wave Axis Deviation, Coronary Artery Disease, Atrial Fibrillation, Heart Failure, Stroke and Cardiovascular Mortality: The MOLI-SANI Study
Background: Deviation of frontal plane T-wave axis (TDev) is a reliable measure of ventricular repolarisation abnormality.
Objectives: We investigated the associations and possible mediators between TDev and the risk of coronary artery disease (CHD), atrial fibrillation (AF), heart failure (HF), stroke and cardiovascular mortality.
Methods: A large sample of 21,287 Moli-sani participants (54.0±10 years, 46% women), randomly recruited from the general adult population of Southern Italy and free of clinically and ECG recognized vascular disease (including HF), were followed for a median of 4.3 years. TDev was measured from a standard 12-lead resting electrocardiogram. ECG abnormalities were identified by the MINNESOTA codes.
Results: After adjusting for a large panel of covariates (see the Table), subjects with abnormal TDev showed a significant increase in the risk of CHD, AF, HF and CVD mortality, but not with stroke (Table). Associations with CHD and HF (but not AF or CVD mortality) were slightly reduced but remained significant after further adjustment for other ECG abnormalities (Table). Subjects with abnormal TDev showed higher levels of subclinical inflammation (measured by C-reactive protein, WBC, platelet counts and ratio of granulocytes to lymphocytes), hs-troponin I and hs-NT-proBNP (p<0.001 for all). However, while additional adjustment for inflammation markers did not change the association of TDev with any clinical outcome, further adjustment for troponin I or NT-proBNP or both determined a reduction ranging from 7.9 to 23.7% for the association of TDev with HF and from 20.7 to 33.8% for the association of TDev with CHD.
Conclusions: Deviation of TDev is associated with an increased risk of HF or CHD, independently from a large panel of covariates and other ECG abnormalities. The association was partially explained by the increase in hs-troponin I and hs-NT-proBNP levels.
Author Disclosures: A. Di Castelnuovo: None. M. Bonaccio: None. S. Costanzo: None. L. Rago: None. A. De Curtis: None. D. Assanelli: None. F. Badilini: None. M. Vaglio: None. M. Persichillo: None. M. Donati: None. G. de Gaetano: None. L. Iacoviello: None.
- © 2017 by American Heart Association, Inc.