title: T-wave axis deviation, metabolic syndrome and estimated cardiovascular risk--in men and women of the MOLI-SANI study.
abstract: OBJECTIVE
  We aimed at investigating the association between T-wave axis deviation, metabolic syndrome (MetS), its components and estimated risk of cardiovascular disease (CVD) at 10 years in an adult Italian population.
  
  
  METHODS
  11,143 women (54 ± 11 years) and 9742 men (55 ± 11 years) were analyzed from the Moli-sani cohort, randomly recruited from the general population. MetS was defined using the ATPIII criteria. T-wave axis deviation was measured from the standard 12-lead resting electrocardiogram. CVD risk in ten years was estimated by the CUORE score.
  
  
  RESULTS
  29% of men and 27% of women with MetS showed borderline or abnormal T-wave as compared to 24% and 17% without MetS (p < 0.0001 for both genders). Among components of MetS, elevated waist and blood pressure were strongly associated with T-wave axis deviation, whereas glucose, HDL and triglycerides were only marginally. The odds of having borderline or abnormal T-wave axis deviation in multivariable regression analysis, was 1.38 (95% CI:1.25-1.53) in MetS men and 1.68 (95% CI:1.51-1.87) in MetS women compared to those without. Further adjustment for MetS components completely abolished the associations. Abnormal T-wave axis deviation was associated with an increased risk of CVD in 10 years in men (OR = 4.4; 95% CI:1.10-17.9).
  
  
  CONCLUSIONS
  T-wave axis deviation is strongly associated with components of the MetS, in particular high waist circumference and blood pressure and with an increased CVD risk, particularly in men. ECG monitoring to identify T-wave axis deviation in obese, hypertensive or MetS subjects can be an early indicator of vascular disease and help in reducing cardiac events.
authors.affiliation: Laboratory of Genetic and Environmental Epidemiology, Research Laboratories, Fondazione di Ricerca e Cura Giovanni Paolo II, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 86100 Campobasso, Italy.
authors.forename: Livia
authors.initials: L
authors.lastname: Rago
authors.forename: Augusto
authors.initials: A
authors.lastname: Di Castelnuovo
authors.forename: Deodato
authors.initials: D
authors.lastname: Assanelli
authors.forename: Fabio
authors.initials: F
authors.lastname: Badilini
authors.forename: Martino
authors.initials: M
authors.lastname: Vaglio
authors.forename: Francesco
authors.initials: F
authors.lastname: Gianfagna
authors.forename: Massimo
authors.initials: M
authors.lastname: Salvetti
authors.forename: Francesco
authors.initials: F
authors.lastname: Zito
authors.forename: Francesco
authors.initials: F
authors.lastname: Alessandrini
authors.forename: Maria Benedetta
authors.initials: MB
authors.lastname: Donati
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Gaetano
authors.forename: Licia
authors.initials: L
authors.lastname: Iacoviello
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007558:Italy / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D008875:Middle Aged; D012306:Risk; D055105:Waist Circumference