Abstract 343: Association Between Electrocardiographic Parameters and Coronary Atherosclerotic Burden in Symptomatic Patients Without History of Coronary Artery Disease
Introduction: Coronary artery calcium score (CACS) and the electrocardiogram (ECG) are tests available in the evaluation and risk stratification of coronary heart disease risk. The aim of this study is to evaluate the association between conduction abnormalities detected by ECG and coronary atherosclerotic burden determined by CACS in symptomatic patients with no history of coronary artery disease (CAD).
Methods: This is a cross-sectional study of 843 consecutive patients without history of CAD who presented with chest pain to our emergency department. All patients were evaluated with ECG and CACS by MDCT. The cohort was categorized into 4 groups: CACS 0, 1-100, 101-400, and >400. PR prolongation was defined as PR interval >200 ms. QTc prolongation was defined as normal (<420 ms), mild (420 [[Unable to Display Character: –]] 440ms) and moderate-to-severe (>440ms). Other ECG parameters evaluated include bundle branch blocks (BBB), ST segment changes, and T wave abnormalities.
Results: The cohort had a mean age of 54 ± 13 years and 44% were male. Median Framingham 10-year risk for cardiovascular disease was 5% (Interquartile range; IQR 1% - 16%). 59% of the cohort had CACS 0; 22.7% (CACS 1-100), 9.5% (CACs 101-400) and 8.8% (CACS >400). PR prolongation was present in 5% of the cohort. 66% had normal QTc and 34% had prolonged QTc - mild (180), moderate-to-severe (105). In multivariate analysis adjusted for Framingham risk, PR prolongation was independently associated with presence (OR 3.22; 95%CI 1.08, 1.12; p<0.001) and severity (CACS>400) of coronary calcification (OR 2.51; 95%CI 1.10, 5.75; p=0.03). Similarly, QTc prolongation was independently associated with presence (mild: OR 1.01; 95%CI 0.70, 1.46; p=0.96, moderate-to-severe: OR 1.64; 95%CI 1.05, 2.56; p=0.03) and severity (CACS>100) of coronary calcification (mild: OR 1.66; 95%CI 1.10, 2.53; p=0.02, moderate-to-severe: OR 2.05; 95%CI 1.26, 3.35; p=0.004). BBB (3.6%), ST segment changes (11.9%), and T wave abnormalities (22.7%) were not associated with the presence or extent of coronary calcification.
Conclusion: In patients without history of CAD, PR and QTc prolongation were independently associated with presence and severity of coronary atherosclerotic burden detected by CACS, while BBB, ST segment and T wave changes were not.
Author Disclosures: R. Adigun: None. K. Chaikriangkrai: None. A. Sunkara: None. M. Cherry: None. S. Chang: None.
- © 2015 by American Heart Association, Inc.