Key result
Prolonged R wave peak time on admission independently predicted in-hospital MACE in acute coronary syndrome patients with an OR of 1.10 per ms increase.
Why the study?
Electrocardiographic parameters have emerged as valuable noninvasive markers for risk stratification in ACS, but the correlation between R wave peak time, CAD severity, and in-hospital MACE needed evaluation.
Does prolonged R wave peak time correlate with coronary artery disease severity and independently predict in-hospital major adverse cardiac events in patients with acute coronary syndrome?
Cohort (n=183)
Outcome assessors (ECG and angiography readers) blinded to clinical data
No
Does prolonged R wave peak time correlate with coronary artery disease severity and independently predict in-hospital major adverse cardiac events in patients with acute coronary syndrome?
Answers are grounded in this paper and cite their sources.
R wave peak time on admission electrocardiograms acts as a simple, noninvasive tool that correlates with angiographic CAD severity and predicts short-term major adverse cardiac events in patients with acute coronary syndrome.
BACKGROUND: Electrocardiographic parameters have emerged as valuable noninvasive markers for risk stratification in acute coronary syndrome (ACS). AIMS: This study aimed to evaluate the correlation between R wave peak time (RWPT) and coronary artery disease (CAD) severity, and to assess its prognostic value for in-hospital major adverse cardiac events (MACE) in ACS patients. METHODS: We retrospectively analyzed 183 ACS patients who underwent coronary angiography at our hospital between January 2020 and December 2023. RWPT, QRS duration, and P wave peak time were measured from admission electrocardiograms. CAD severity was quantified using the Gensini score, with patients classified into mild (score < 25, n = 81) and moderate-severe (score ≥ 25, n = 102) groups. In-hospital MACE was systematically recorded during hospitalization. RESULTS: RWPT demonstrated a strong positive correlation with the Gensini score (r = 0.7, p < 0.001). Patients with moderate-severe CAD exhibited significantly prolonged RWPT compared to those with mild disease (43.2 ± 6.3 vs. 36.8 ± 5.3 ms, p < 0.001). Similarly, patients who experienced MACE had significantly longer RWPT than those without complications (44.7 ± 6.2 vs. 37.1 ± 5.5 ms, p < 0.001). In-hospital MACE occurred in 25 patients (13.7%). Multivariate logistic regression analysis identified both RWPT (OR: 1.10, 95% CI: 1.05-1.15, p < 0.001) and diabetes mellitus (OR: 3.02, 95% CI: 1.16-7.93, p = 0.024) as independent risk factors of in-hospital MACE. CONCLUSION: RWPT measured on admission electrocardiograms correlates significantly with CAD severity and independently predicts in-hospital MACE in ACS patients. As a simple, readily available parameter, RWPT may enhance risk stratification in ACS, particularly in resource-limited settings where advanced imaging or biomarker testing access is constrained.
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Xu et al. (2025) conducted a cohort in Acute Coronary Syndrome (ACS) (n=183). Prolonged R wave peak time (RWPT) vs. Shorter R wave peak time was evaluated on In-hospital major adverse cardiac events (MACE), composite of cardiac death, recurrent MI, cardiogenic shock, malignant ventricular arrhythmias, or urgent revascularization (OR 1.10, 95% CI 1.05-1.15, p=< 0.001). Prolonged R wave peak time on admission independently predicted in-hospital MACE in acute coronary syndrome patients with an OR of 1.10 per ms increase.
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