PROGNOSTIC SIGNIFICANCE OF PTFV1 IN DETERMINING LONG-TERM OUTCOMES IN INDIVIDUALS WITH UNSTABLE ANGINA.
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Keywords
P-wave terminal force in lead V1, Left ventricular diastolic dysfunction, valvular heart disease, major adverse cardiovascular events, unstable angina.
Abstract
Diverse cardiovascular conditions, such as atrial fibrillation, left ventricular diastolic dysfunction, valvular heart disease, congestive heart failure, stroke, and mortality, have been linked to P-wave terminal force in lead V1 (PtfV1) irregularity. However, its prognostic value for unstable angina has not been extensively investigated. To fill this knowledge gap, the purpose of this investigation was to assess the long-term predictive value of PtfV1 at discharge for unstable angina patients. Hence, the present study aimed to determine the prognostic significance of PtfV1 and long-term outcomes of patients with unstable angina. Methods: A total of 100 patients who had recently been diagnosed with unstable angina were included. Measurements of PtfV1 levels were obtained upon admission and discharge. In this context, PtfV1(+) denoted an absolute value greater than 0.04 mm·s, whereas PtfV1(-) denoted an absolute value less than 0.04 mm·s. Patients were classified into two categories, PtfV1(−) and PtfV1(+), according to their PtfV1 values at discharge. Univariate and multivariate regression analyses were performed to ascertain the prospective risk factors for unstable angina. The findings from the univariate analysis indicated that the PtfV1+ group had a greater occurrence of major adverse cardiovascular events (MACE) and total adverse outcomes (TAKEN) than the PtfV1-group. The risk ratio (RR) for TAKEN was 3.117 (95% confidence interval [CI]: 2.490–3.9067) for MACE and 3.860 (95% CI: 2.981–5.181) for AOE. Participants with PtfV1(+) had a 48 % increased risk [adjusted hazard ratio (HR): 2.569; 95% CI: 2.121–3.215] for total adverse outcomes and an 86% increased risk (adjusted HR: 2.974; 95% CI: 2.357–3.8967) for MACE compared to those with PtfV1(-), after adjusting for confounding factors via multivariate analysis. In conclusion, the presence of PtfV1+ at the time of discharge serves as an extended prognostic indicator for patients with unstable angina and is an independent predictor of unfavorable outcomes.
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Dr Jitendra Naik
Designation- ASSISTANT PROFESSOR, Department of Medicine, Medical College- VIMSAR, BURLA, ODISHA.
Dr Desabandhu Behera
Designation- ASSISTANT PROFESSOR, Department- Department of Medicine, Medical College- SCB MCH, Cuttack, Odisha
Dr Gouri Oram
Designation- ASSOCIATE PROFESSOR, Department- Department of Medicine, Medical College- VIMSAR, Burla, Sambalpur, Odisha.
Dr Shashi Bhusan Sutar
Designation- ASSISTANT PROFESSOR, Department- Department of Medicine, Medical College- VIMSAR, BURLA.ODISHA