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Electrocardiographic T-wave morphology and risk of mortality

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@article{19d41a8ebeec465c995764a1f5e58661,
title = "Electrocardiographic T-wave morphology and risk of mortality",
abstract = "BACKGROUND: Electrocardiographic T-wave morphology is used in drug safety studies as an adjunct to the QTc interval, but few measurements of T-wave morphology can be interpreted in clinical practice. Morphology combination score (MCS) is a combination of T-wave flatness/peakedness, asymmetry, and notching, enabling easy visual assessment of T-wave morphology. We aimed to test the association between T-wave morphology, quantified by MCS, and mortality.METHODS: We included electrocardiograms recorded in 2001-2011 from 342,294 primary care patients. Using Cox regression, we evaluated the association between MCS, cardiovascular death, and all-cause mortality, adjusting for heart rate, QTc, QT-prolonging drugs, diabetes, ischemic heart disease, hypertension, and congestive heart failure.RESULTS: 270,039 individuals (44% men, median age 55 [inter-quartile range: 42-67 years]) were included and followed for a median of 9.3 years, during which time 13,489 (5.0%) died from cardiovascular causes and 50,481 (18.7%) from any cause. High values of MCS (i.e. asymmetric, flattened, and/or notched T waves) were associated with an adjusted mortality Hazard Ratio of 1.75 (95% CI 1.62-1.89) and 1.61 (1.43-1.92) for women and men, respectively. Low values of MCS (i.e. peaked and symmetric T waves) were associated with a Hazard Ratio of 1.18 (1.08-1.28) and 1.71 (1.48-1.98) for women and men, respectively.CONCLUSIONS: In a large primary care population, we found that T-wave asymmetry, flatness, and notching provided prognostic information on mortality independent of heart rate, QTc, and baseline comorbidities.",
keywords = "All-cause mortality, Cardiovascular death, Electrocardiogram, Electrocardiography, QT interval, T-wave morphology",
author = "Isaksen, {Jonas L} and Jonas Ghouse and Claus Graff and Olesen, {Morten S} and Holst, {Anders G} and Adrian Pietersen and Nielsen, {Jonas B} and Skov, {Morten W} and Kanters, {J{\o}rgen K}",
note = "Copyright {\textcopyright} 2020 Elsevier B.V. All rights reserved.",
year = "2021",
month = apr,
day = "1",
doi = "10.1016/j.ijcard.2020.12.016",
language = "English",
volume = "328",
pages = "199--205",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

RIS

TY - JOUR

T1 - Electrocardiographic T-wave morphology and risk of mortality

AU - Isaksen, Jonas L

AU - Ghouse, Jonas

AU - Graff, Claus

AU - Olesen, Morten S

AU - Holst, Anders G

AU - Pietersen, Adrian

AU - Nielsen, Jonas B

AU - Skov, Morten W

AU - Kanters, Jørgen K

N1 - Copyright © 2020 Elsevier B.V. All rights reserved.

PY - 2021/4/1

Y1 - 2021/4/1

N2 - BACKGROUND: Electrocardiographic T-wave morphology is used in drug safety studies as an adjunct to the QTc interval, but few measurements of T-wave morphology can be interpreted in clinical practice. Morphology combination score (MCS) is a combination of T-wave flatness/peakedness, asymmetry, and notching, enabling easy visual assessment of T-wave morphology. We aimed to test the association between T-wave morphology, quantified by MCS, and mortality.METHODS: We included electrocardiograms recorded in 2001-2011 from 342,294 primary care patients. Using Cox regression, we evaluated the association between MCS, cardiovascular death, and all-cause mortality, adjusting for heart rate, QTc, QT-prolonging drugs, diabetes, ischemic heart disease, hypertension, and congestive heart failure.RESULTS: 270,039 individuals (44% men, median age 55 [inter-quartile range: 42-67 years]) were included and followed for a median of 9.3 years, during which time 13,489 (5.0%) died from cardiovascular causes and 50,481 (18.7%) from any cause. High values of MCS (i.e. asymmetric, flattened, and/or notched T waves) were associated with an adjusted mortality Hazard Ratio of 1.75 (95% CI 1.62-1.89) and 1.61 (1.43-1.92) for women and men, respectively. Low values of MCS (i.e. peaked and symmetric T waves) were associated with a Hazard Ratio of 1.18 (1.08-1.28) and 1.71 (1.48-1.98) for women and men, respectively.CONCLUSIONS: In a large primary care population, we found that T-wave asymmetry, flatness, and notching provided prognostic information on mortality independent of heart rate, QTc, and baseline comorbidities.

AB - BACKGROUND: Electrocardiographic T-wave morphology is used in drug safety studies as an adjunct to the QTc interval, but few measurements of T-wave morphology can be interpreted in clinical practice. Morphology combination score (MCS) is a combination of T-wave flatness/peakedness, asymmetry, and notching, enabling easy visual assessment of T-wave morphology. We aimed to test the association between T-wave morphology, quantified by MCS, and mortality.METHODS: We included electrocardiograms recorded in 2001-2011 from 342,294 primary care patients. Using Cox regression, we evaluated the association between MCS, cardiovascular death, and all-cause mortality, adjusting for heart rate, QTc, QT-prolonging drugs, diabetes, ischemic heart disease, hypertension, and congestive heart failure.RESULTS: 270,039 individuals (44% men, median age 55 [inter-quartile range: 42-67 years]) were included and followed for a median of 9.3 years, during which time 13,489 (5.0%) died from cardiovascular causes and 50,481 (18.7%) from any cause. High values of MCS (i.e. asymmetric, flattened, and/or notched T waves) were associated with an adjusted mortality Hazard Ratio of 1.75 (95% CI 1.62-1.89) and 1.61 (1.43-1.92) for women and men, respectively. Low values of MCS (i.e. peaked and symmetric T waves) were associated with a Hazard Ratio of 1.18 (1.08-1.28) and 1.71 (1.48-1.98) for women and men, respectively.CONCLUSIONS: In a large primary care population, we found that T-wave asymmetry, flatness, and notching provided prognostic information on mortality independent of heart rate, QTc, and baseline comorbidities.

KW - All-cause mortality

KW - Cardiovascular death

KW - Electrocardiogram

KW - Electrocardiography

KW - QT interval

KW - T-wave morphology

UR - http://www.scopus.com/inward/record.url?scp=85098225220&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2020.12.016

DO - 10.1016/j.ijcard.2020.12.016

M3 - Journal article

C2 - 33321127

VL - 328

SP - 199

EP - 205

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -

ID: 61995179