Clinical value of the combined use of P-wave dispersion and troponin values to predict atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation

Introduction: P-wave dispersion (PWD) and cardiac troponin levels are independently associated with the recurrence of atrial fibrillation (AF) in patients with paroxysmal AF (PAF). We investigated the clinical usefulness of combining PWD and cardiac troponin I to predict AF recurrence in patients pr...

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Bibliographic Details
Main Authors: Metin Ocak, Mustafa Begenc Tascanov
Format: Article
Language:English
Published: Elsevier 2021-09-01
Series:Revista Portuguesa de Cardiologia (English Edition)
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Online Access:http://www.sciencedirect.com/science/article/pii/S2174204921002555
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Summary:Introduction: P-wave dispersion (PWD) and cardiac troponin levels are independently associated with the recurrence of atrial fibrillation (AF) in patients with paroxysmal AF (PAF). We investigated the clinical usefulness of combining PWD and cardiac troponin I to predict AF recurrence in patients presenting to the emergency department with PAF. Methods: This study included 65 patients with PAF who were divided into three groups according to baseline troponin I and PWD values (group 1, troponin I<0.11 ng/dl and PWD<44.5 ms; group II, troponin I<0.11 ng/dl and PWD≥44.5 ms, or troponin I≥0.11 ng/dl and PWD<44.5 ms; group III, troponin I≥0.11 ng/dl and PWD≥44.5 ms). Results: The AF recurrence rate was significantly higher in group III than in groups I and II. Multivariate analysis revealed that the troponin I and PWD values in group III (odds ratio: 7.236, 95% confidence interval: 1.879-27.861, p=0.004) were independent predictors of AF recurrence. Conclusions: The combined use of PWD and basal troponin I levels is a better predictor of AF recurrence than either value alone. Resumo: Objetivos: A dispersão da onda P (DOP) e os níveis séricos de troponina cardíaca estão independentemente associados à recidiva de fibrilhação auricular (FA) em doentes com FA paroxística (FAP). Estudámos a utilidade clínica da combinação entre a DOP e a troponina cardíaca I para prever a recidiva de FA em doentes que se apresentaram no serviço de urgência com FAP. Métodos: Este estudo incluiu 65 doentes com FAP, divididos em três grupos de acordo com a troponina I basal e com os valores da DOP (grupo 1, <0,11 ng/dL e DOP<44,5 ms; grupo II, troponina I<0,11 ng/dL e DOP≥44,5 ms, ou troponina I≥0,11 ng/dL e DOP<44,5 ms; grupo III, troponina I≥0,11ng/dL e DOP≥44,5 ms). Resultados: A recorrência de FA foi significativamente mais elevada no grupo III do que nos grupos I e II. A análise multivariada revelou que a troponina I e os valores da DOP no grupo III (odds ratio: 7,236, intervalo de confiança 95%: 1,879-27,861, p=0,004) foram preditores independentes da recidiva de FA. Conclusões: A utilização combinada da DOP e dos níveis de troponina I basal constitui um melhor preditor de recidiva de FA do que os dois valores isolados.
ISSN:2174-2049