Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China.
Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China.
J Electrocardiol. 2024 May-Jun;84:137-144. doi: 10.1016/j.jelectrocard.2024.04.004. Epub 2024 Apr 26.
Metabolic syndrome (MetS) is associated with increased rates of cardiovascular disease and mortality and is linked to abnormal electrocardiogram (ECG) parameters. We aimed to explore the relationships and interactions among MetS and its components, abnormal P-wave axis (aPWA), and mortality rates.
We analyzed data from 7526 adult participants with sinus rhythm recruited from the National Health and Nutrition Examination Survey III. MetS was classified based on the NCEP ATP III-2005 definition. aPWA included all P-wave axis outside 0-75°. The National Death Index was utilized to identify survival status. Hazard ratios (HRs) and 95% confidence intervals (CIs) categorized by aPWA, MetS, and their components were analyzed using Cox proportional hazards models to investigate all-cause and cardiovascular mortalities.
Within a median follow-up period of 20.76 years, 4686 deaths were recorded, of which 1414 were attributable to cardiovascular disease. Participants with both MetS and aPWA had higher all-cause (HR: 1.45, 95% CI: 1.29-1.64, interaction P = 0.043) and cardiovascular (HR: 1.36, 95% CI: 1.02-1.79, interaction P-value = 0.058) mortality rates than participants without MetS and with a normal P-wave axis. Participants with the greatest number of MetS components and aPWA had a higher risk of all-cause mortality (HR: 1.70, 95% CI: 1.13-2.55, P = 0.011).
Individuals with both aPWA and MetS have a higher risk of mortality, and those with a greater number of MetS components and aPWA have a higher risk of all-cause mortality. These findings highlight the significance of integrating ECG characteristics with metabolic health status in clinical assessment.
代谢综合征（MetS）与心血管疾病和死亡率的增加有关，并且与异常心电图（ECG）参数有关。我们旨在探讨 MetS 及其成分、异常 P 波轴（aPWA）与死亡率之间的关系和相互作用。
我们分析了来自国家健康和营养检查调查 III 的 7526 名窦性节律成年参与者的数据。MetS 根据 NCEP ATP III-2005 定义进行分类。aPWA 包括所有 P 波轴在 0-75°之外的情况。利用国家死亡指数确定生存状态。使用 Cox 比例风险模型分析按 aPWA、MetS 及其成分分类的危险比（HR）和 95%置信区间（CI），以调查全因和心血管死亡率。
在中位随访期 20.76 年内，记录了 4686 例死亡，其中 1414 例归因于心血管疾病。同时患有 MetS 和 aPWA 的参与者的全因（HR：1.45，95%CI：1.29-1.64，交互 P=0.043）和心血管（HR：1.36，95%CI：1.02-1.79，交互 P 值=0.058）死亡率均高于无 MetS 且 P 波轴正常的参与者。MetS 成分和 aPWA 数量最多的参与者全因死亡率风险更高（HR：1.70，95%CI：1.13-2.55，P=0.011）。
同时患有 aPWA 和 MetS 的个体死亡风险更高，且 MetS 成分和 aPWA 数量较多的个体全因死亡风险更高。这些发现强调了在临床评估中整合心电图特征与代谢健康状况的重要性。
