Abstract
BACKGROUND: P-wave terminal force in V1 (PTFV1) on electrocardiography is an easily available and cost-effective surrogate marker reflecting myocardial electrical and structural remodeling. An abnormal PTFV1 was recently suggested to be a reliable predictor of adverse cardiovascular events, whereas its performance in the setting of coronary artery disease (CAD) remains unknown. METHODS: We retrospectively investigated 3147 patients with CAD who underwent percutaneous coronary intervention at our institution. Abnormal PTFV1 was defined as PTFV1 >0.04 mm⋅s. The primary outcome was a composite of cardiac death and heart failure hospitalization. The Cox proportional hazard models were constructed to investigate the association between PTFV1 and clinical outcome. RESULTS: Among the study population, 592 (18.8 %) patients had abnormal PTFV1. Patients with abnormal PTFV1 had worse atherosclerotic and cardiovascular profiles, higher concentrations of brain natriuretic peptide and C-reactive protein, and more advanced CAD than those with normal PTFV1 (p < 0.05). The abnormal PTFV1 group had more pronounced left ventricular and atrial remodeling than normal PTFV1 group (p < 0.05), but the association between left atrial size and PTFV1 was not significant after multivariable adjustment (p = 0.355). During a median follow-up of 5.2 years, patients with abnormal PTFV1 more frequently experienced the primary outcome than those with normal PTFV1 (log-rank p < 0.001). Abnormal PTFV1 carried a significant risk for the primary outcome independent of baseline characteristics, biomarkers, and angiographic features (adjusted hazard ratio 2.38, p < 0.001). CONCLUSIONS: In patients with CAD who undergo percutaneous coronary intervention, abnormal PTFV1 is a robust and independent risk factor for adverse cardiovascular outcomes.