[en] Aims Although a resting electrocardiograph is broadly applied in clinical practice for evaluating patientswith Type 2 diabetes
and cardiovascular disease, the independent prognostic relevance of electrocardiographic signs has not thoroughly been
examined.
Methods Baseline 12-lead electrocardiographs available in 5231 of the 5238 participants of the PROactive trial were analysed
for heart rate, heart rate corrected QT-interval, presence of atrial fibrillation ⁄ flutter, left axis deviation, right and left bundle
branch block. The association of electrocardiographic signs with total mortality, the principal secondary composite endpoint
(death, myocardial infarction and stroke) and serious adverse heart failure events was examined by Cox-regression analysis.
Results Two hundred and twenty-three (4.3%) patients showed atrial fibrillation ⁄ flutter, 213 (4.1%) patients had right
bundle branch block, 111 (2.1%) patients had left bundle branch block and 706 (13.5%) patients had left axis deviation. Mean
cQT-interval was 418 ms ( 25 ms) and mean heart ratewas 72 ⁄min ( 14 ⁄ min). Inmultivariate adjusted analyses, heart rate
and cQT-interval were significantly associated with mortality, the composite secondary endpoint and heart failure, whereas
right and left bundle branch blockswere significantly associated with heart failure only. Left axis deviationwas associated with
heart failure and atrial fibrillation ⁄ flutter was associated with mortality and heart failure in univariate but not multivariate
analyses.
Conclusion Easily assessable electrocardiographic signs such as heart rate, cQT-interval and bundle branch blocks were
predictive for adverse outcome independently of multiple risk factor adjustment and should be considered in clinical care.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Pfister, R.
Cairns, R.
Erdmann, E.
Schneider, C. A.
SCHEEN, André ; Centre Hospitalier Universitaire de Liège - CHU > Diabétologie,nutrition, maladies métaboliques
PROactive investigators
Language :
English
Title :
Prognostic impact of electrocardiographic signs in patients with Type 2 diabetes and cardiovascular disease: results from the PROactive study
Publication date :
2011
Journal title :
Diabetic Medicine: A Journal of the British Diabetic Association
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