Advanced interatrial block is associated with worst prognosis in patients with previous coronary acute syndrome

Advanced interatrial block is associated with worst prognosis in patients with previous coronary acute syndrome

Abstract Background The interatrial block (IAB) has been directly related to the appearance of several atrial tachyarrhythmias. The objective of this study is to establish whether the duration of p wave could predict the appearance of atrial fibrillation (AF), death or stroke in patients with a prev...

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Published in:European heart journal Vol. 41; no. Supplement_2
Main Authors: Garcia Talavera, C.S, Acena Navarro, A, Esteban-Chapel, J.A, Camblor Blasco, A, Franco Pelaez, J.A, Pello Lazaro, A.M, Lopez Castillo, M, Martin Mariscal, M, Hernandez Gonzalez, I, Venegas Rodriguez, A.M, Canovas Rodriguez, E, Kallmeyer Mayor, A, Tunon Fernandez, J
Format: Journal Article
Language:English
Published: 01-11-2020
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Summary:Abstract Background The interatrial block (IAB) has been directly related to the appearance of several atrial tachyarrhythmias. The objective of this study is to establish whether the duration of p wave could predict the appearance of atrial fibrillation (AF), death or stroke in patients with a previous acute coronary syndrome (ACS). Methods We have reviewed all ECG of patients with an ACS admitted to our hospital from July 2006 to June 2014 looking for advanced IAB defined as (P-wave duration was ≥120 ms and presented biphasic morphology), excluding those patients with previous AF and who received anticoagulant therapy. These patients were part of the population of the BACS & BAMI (Biomarkers in Acute Coronary Syndrome & Biomarkers in Acute Myocardial Infarction) studies. For all patients we have determined their cardiovascular risk factors. The primary outcome was a combined endpoint that included death, stroke and development of AF. Cox regression was used for the analysis. Results A total of 423 patients were included, the mean age was 67.8 years (± 14), and 72.3% were male. Only 12 patients (2.8%) presented advanced IAB. After a median follow-up of 54.7 months, there were 51 events (21 deaths (41.2%) were observed, 17 patients (33.3%) had experienced stroke, and 13 patients (25.5%) had developed AF). Patients with development of primary endpoint were older with higher rates of cardiovascular risk factors, advance IAB and diuretic treatment at discharge. After a multivariate Cox regression analysis, advanced IAB [HR=2.65 (1.03–6.86); p=0.044], age [HR=1.06 (1.03–1.09) per year; p<0.001] and diuretic treatment at discharge of ACS [HR=1.87 (1.03–3.39); p=0.039] were independent predictors of worse prognosis. Conclusion Advanced IAB in ECG at admission with ACS could be a predictor of stroke, development of AF or death in follow up. Funding Acknowledgement Type of funding source: None
ISSN:0195-668X
1522-9645
DOI:10.1093/ehjci/ehaa946.0374