Abstract

BACKGROUND: The aim of this study was to evaluate the relationship between P wave and QT dispersions (PWD and QTD) during the course of severe peripheral artery disease (PAD).

MATERIAL AND METHODS: We recruited 163 patients who underwent peripheral angiography (PA) between August 2011 and March 2017, and they were divided into 2 groups according to the severity of PAD on PA. PWD and QTD were investigated using 12-lead electrocardiograms. Group One consisted of patients diagnosed with <70% stenosis on PA, who eventually received medical treatment; Group Two consisted of patients diagnosed with ≥70% stenosis on PA, who eventually underwent surgery.

RESULTS: ROC curve analysis of the 2 groups demonstrated that PWD was significantly higher in Group Two (AUC: 0.913505; 95% confidence interval (CI): 0.859365 to 0.951788; p<0.0001). The Youden index showed that a cut-off PWD value of >35 msn predicted a peripheral artery stenosis of ≥70% with a sensitivity of 88.89% and a specificity of 85.37% (+LR: 6.07, –LR: 0.13). Moreover, QTD was significantly higher in Group Two (AUC: 0.884749; 95% CI: 0.825489 to 0.929391; p<0.0001). Youden index showed that a cut-off QTD value of >75 msn predicted a peripheral artery stenosis of ≥70% with a sensitivity of 76.54% and a specificity of 85.37% (+LR: 5.23, –LR: 0.27). Comparison of ROC curves showed no difference in terms of predicting peripheral artery stenosis of ≥70% between PWD and QTD (p=0.3308).

CONCLUSIONS: Interpreting PWD and QTD offers a non-invasive and cost-effective assessment method for detecting patients at high risk for coronary artery disease in the context of severe PAD.

Keywords: Coronary Artery Disease, Electrocardiography, peripheral arterial disease