A planar QRS-T angle >90 degrees is associated with multivessel coronary artery disease in patients undergoing coronary angiography.
BACKGROUND
The aim of the study was to investigate the severity of coronary artery disease (CAD) in patients who had a planar QRS-T angle >90 degrees versus <or=90 degrees.


METHODS
Coronary angiography was performed in 1,229 consecutive patients. Obstructive CAD was diagnosed if there was >50% obstruction of >or=1 major coronary artery. All QRS-T angle measurements were made from a 12-lead electrocardiogram by 2 authors who agreed on the measurement and who were blinded to the coronary angiographic findings. A QRS-T angle >90 degrees was considered abnormal.


RESULTS
Obstructive CAD of 2 or 3 vessels was present in 309 of 495 patients (62%) with a planar QRS-T angle >90 degrees and in 250 of 734 patients (34%) with a planar QRS-T angle <or=90 degrees . (p<0.0001). Stepwise logistic regression analyses showed that significant independent risk factors for 2- or 3-vessel CAD were age (odds ratio =1.05), male gender (odds ratio =1.8), black race (odds ratio =0.34), unstable angina (odds ratio =0.16), positive stress test (odds ratio =3.0), hypertension (odds ratio =3.0), dyslipidemia (odds ratio =2.9), QRS-T angle (odds ratio =7.2), left bundle branch block (odds ratio =2.9), right bundle branch block (odds ratio =0.17), smoking (odds ratio =9.7), and body mass index >or=30 kg/m2 (odds ratio =1.5).


CONCLUSIONS
The prevalence of 2- or 3-vessel obstructive CAD was significantly higher in patients with a planar QRS-T angle >90 degrees than in patients with a planar QRS-T angle <or=90 degrees (p<0.0001).
Palaniswamy
Chandrasekar
C
Department of Medicine, Cardiology Division, New York Medical College, Valhalla, NY 10595, USA.
Singh
Tarunjit
T
Aronow
Wilbert S
WS
Ahn
Chul
C
Kalapatapu
Kumar
K
Weiss
Melvin B
MB
Pucillo
Anthony L
AL
Monsen
Craig E
CE
D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000473:pathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors