title: P-wave morphologic characteristics predict cardiovascular events in a community-dwelling population.
abstract: BACKGROUND
  There have been few reports on the relationship between P-wave characteristics and long-term cardiovascular events.
  
  
  METHODS
  A nested case-control study was conducted as part of the Jichi Medical School cohort study, which enrolled 12,490 subjects in a community-dwelling population. The mean follow-up period was 10.7 years. The P-wave characteristics of 526 patients who suffered cardiovascular events (fatal/nonfatal stroke, fatal/nonfatal myocardial infarction, and sudden death) within the follow-up period (case group) were compared with those of 1578 matched controls (control group). The P-wave morphology was classified as normal, deflected, and notched type in precordial leads. A broad P wave was defined as a maximum P-wave duration of more than 120 ms in any of the 12 leads.
  
  
  RESULTS
  The mean age was 64 ± 8 years and the percentage of males was 54% in both groups. A notched P wave at baseline was observed in 10.1% of the case group and 6.0% of the control group (P = 0.001). A notched P wave was a significant predictor of cardiovascular events after adjustment for covariates (odds ratio = 1.59; 95% confidence interval = 1.08-2.33). Among the patients with left ventricular hypertrophy as evaluated by the Sokolow-Lyon criteria or Cornell product criteria, there was no significant difference in cardiovascular events between those with and those without a notched P wave, but in the absence of left ventricular hypertrophy, patients with a notched P wave suffered more cardiovascular events than those without a notched P wave by each criteria.
  
  
  CONCLUSIONS
  P-wave morphologic characteristics were effective for predicting cardiovascular events.
authors: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan. kabu@jichi.ac.jp
authors: Tomoyuki
authors: T
authors: Kabutoya
authors: Shizukiyo
authors: S
authors: Ishikawa
authors: Joji
authors: J
authors: Ishikawa
authors: Satoshi
authors: S
authors: Hoshide
authors: Kazuomi
authors: K
authors: Kario
mesh_terms: D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D016022:Case-Control Studies; D016001:Confidence Intervals; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012016:Reference Values; D012111:Residence Characteristics; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D013997:Time Factors