Several ECG abnormalities predicted incident atrial fibrillation in both nonhypertensive and hypertensive individuals but provided only marginal incremental predictive value (delta AUC 0.000-0.005).
Cohort (n=5,813)
Yes
Do ECG abnormalities predict incident atrial fibrillation in nonhypertensive and hypertensive individuals?
While several ECG abnormalities are associated with incident atrial fibrillation in both hypertensive and nonhypertensive individuals, they provide only marginal incremental value for clinical risk prediction.
OBJECTIVE: The aim of this study was to compare the predictive value of ECG abnormalities for atrial fibrillation in nonhypertensive versus hypertensive individuals. METHODS: We recorded ECG and measured conventional cardiovascular risk factors in a nationwide population-based sample of 5813 Finns. We divided the participants into nonhypertensive (n = 3148) and hypertensive (n = 2665) individuals and followed the participants for incident atrial fibrillation events. We evaluated the predictive ability of 12 ECG abnormalities for atrial fibrillation using multivariable-adjusted Fine-Gray models. RESULTS: During a follow-up of 11.9 ± 2.9 years, 111 nonhypertensive and 301 hypertensive participants developed atrial fibrillation. Negative T wave in lateral leads predicted atrial fibrillation in both nonhypertensive hazard ratio (HR), 4.59; 95% confidence interval (95% CI) 1.84-11.44 and hypertensive participants (HR, 1.81; 95% CI 1.16-2.84). In nonhypertensive participants, 1-SD increments in corrected QT interval (HR, 1.42; 95% CI, 1.18-1.71) and T-wave amplitude in lead augmented vector R (aVR) (HR, 1.40; 95% CI, 1.10-1.80) were related to atrial fibrillation. In hypertensive participants, prolonged PR interval (HR, 1.59; 95% CI 1.05-2.41), prolonged P-wave duration (HR, 1.43; 95% CI 1.07-1.91), left ventricular hypertrophy by Sokolow-Lyon criteria (HR, 1.55; 95% CI, 1.12-2.14) and poor R-wave progression (HR, 1.59; 95% CI, 1.02-2.48) predicted atrial fibrillation. Corrected QT interval and T-wave amplitude in lead aVR were stronger predictors of atrial fibrillation in nonhypertensive than in hypertensive participants. ECG abnormalities improved risk prediction only marginally (delta area under receiver-operating-characteristic curve = 0.000-0.005). CONCLUSION: Several ECG abnormalities associate with incident atrial fibrillation in hypertensive and nonhypertensive individuals but provide only marginal incremental predictive value. Corrected QT interval and T-wave amplitude in lead aVR may relate stronger to incident atrial fibrillation in nonhypertensive than in hypertensive individuals.
Lehtonen et al. (Thu,) conducted a cohort in atrial fibrillation (n=5,813). 12 ECG abnormalities was evaluated on incident atrial fibrillation. Several ECG abnormalities predicted incident atrial fibrillation in both nonhypertensive and hypertensive individuals but provided only marginal incremental predictive value (delta AUC 0.000-0.005).
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