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首页> 外文期刊>The American Journal of Cardiology >Association of P-Wave Axis With Incident Atrial Fibrillation in Diabetes Mellitus (from the ACCORD Trial)
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Association of P-Wave Axis With Incident Atrial Fibrillation in Diabetes Mellitus (from the ACCORD Trial)

机译:P波轴与入射心房颤动在糖尿病(从Accord试验)中的关系

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摘要

Abnormal P-wave axis may reflect preclinical atrial dysfunction and has been associated with an increased risk of incident atrial fibrillation (AF) in the general population. Patients with diabetes mellitus (DM) have a higher prevalence of AF, but the association of abnormal P-wave axis and the risk of incident AF in those with diabetes has not been previously explored. For this analysis, we included 8,965 eligible participants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. P-wave axis was automatically measured on study electrocardiogram and visually confirmed, with the normal range being between 0 degrees and 75 degrees. At baseline, 8% of the study population had an abnormal P-wave axis. During 43,856 person-years of follow-up, there were 145 cases of incident AF. Using multivariable-adjusted Cox proportional hazards models, participants with abnormal P-wave axis had an increased risk of incident AF (hazard ratio 2.65, 95% confidence interval 1.76 to 3.99, p < 0.0001). Findings were similar in prespecified subgroups, without evidence of effect modification. Both left- and right-axis deviation of the P-wave were associated with incident AF. Our results suggest that abnormal P-wave axis is associated with incident AF in those with DM and that this relation is conserved in prespecified subgroups. There may be utility in considering P-wave axis values from routine ECGs in these patients. (C) 2020 Elsevier Inc. All rights reserved.
机译:P波轴异常可能反映临床前心房功能障碍,并与普通人群发生房颤(AF)的风险增加有关。糖尿病(DM)患者的房颤患病率较高,但糖尿病患者的异常P波轴与房颤发生风险之间的关系尚未被探讨。在这项分析中,我们纳入了8965名来自糖尿病心血管风险控制行动(ACCORD)试验的合格参与者。在研究心电图上自动测量P波轴,并进行目视确认,正常范围为0度至75度。在基线检查时,8%的研究人群有异常的P波轴。在43856人-年的随访中,共有145例发生房颤。使用多变量调整Cox比例风险模型,P波轴异常的参与者发生房颤的风险增加(风险比2.65,95%可信区间1.76至3.99,P<0.0001)。在预先指定的亚组中,结果相似,没有证据表明效果改变。P波的左、右轴偏移均与入射房颤相关。我们的结果表明,在DM患者中,异常P波轴与入射房颤相关,并且这种关系在预先指定的亚组中保持不变。考虑这些患者常规心电图的P波轴值可能有用。(C) 2020爱思唯尔公司版权所有。

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