ArticleBMC cardiovascular disorders2017
PR interval prolongation in coronary patients or risk equivalent: excess risk of ischemic stroke and vascular pathophysiological insights.
Article in BMC cardiovascular disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Brazilian Guideline for Exercise Test in the Adult Population - 2024.Arquivos brasileiros de cardiologia · 2024Guideline
- Vascular function assessed by flow-mediated vasodilation and nitroglycerine-induced vasodilation in subjects with first-degree atrioventricular block.Scientific reports · 2024Article
- Can prolonged P-R interval predict clinical outcomes in non-ST elevation acute coronary syndrome patients?BMC cardiovascular disorders · 2024Article
- Prognostic significance of first-degree atrioventricular block in a large Asian population: a prospective cohort study.BMJ open · 2022Article
- PR interval prolongation and 1-year mortality among emergency department patients: a multicentre transnational cohort study.BMJ open · 2021Article
- Epidemiology and Outcomes Associated with PR Prolongation.Cardiac electrophysiology clinics · 2021Review
- A Mendelian randomization analysis of the relationship between cardioembolic risk factors and ischemic stroke.Scientific reports · 2021Article
- Develop and Apply Electrocardiography-Based Risk Score to Identify Community-Based Elderly Individuals at High-Risk of Mortality.Frontiers in cardiovascular medicine · 2021Article
- Osteogenic circulating endothelial progenitor cells are linked to electrocardiographic conduction abnormalities in rheumatic patients.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2019Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhether PR prolongation independently predicts new-onset ischemic events of myocardial infarction and stroke was unclear. Underlying pathophysiological mechanisms of PR prolongation leading to adverse cardiovascular events were poorly understood. We investigated the role of PR prolongation in pathophysiologically-related adverse cardiovascular events and underlying mechanisms.
methodsWe prospectively investigated 597 high-risk cardiovascular outpatients (mean age 66 ± 11 yrs.; male 67%; coronary disease 55%, stroke 22%, diabetes 52%) for new-onset ischemic stroke, myocardial infarction (MI), congestive heart failure (CHF), and cardiovascular death. Vascular phenotype was determined by carotid intima-media thickness (IMT).
resultsPR prolongation >200 ms was present in 79 patients (13%) at baseline. PR prolongation >200 ms was associated with significantly higher mean carotid IMT (1.05 ± 0.37 mm vs 0.94 ± 0.28 mm, P = 0.010). After mean study period of 63 ± 11 months, increased PR interval significantly predicted new-onset ischemic stroke (P = 0.006), CHF (P = 0.040), cardiovascular death (P < 0.001), and combined cardiovascular endpoints (P < 0.001) at cut-off >200 ms. Using multivariable Cox regression, PR prolongation >200 ms independently predicted new-onset ischemic stroke (HR 8.6, 95% CI: 1.9-37.8, P = 0.005), cardiovascular death (HR 14.1, 95% CI: 3.8-51.4, P < 0.001) and combined cardiovascular endpoints (HR 2.4, 95% CI: 1.30-4.43, P = 0.005). PR interval predicts new-onset MI at the exploratory cut-off >162 ms (C-statistic 0.70, P = 0.001; HR: 8.0, 95% CI: 1.65-38.85, P = 0.010).
conclusionsPR prolongation strongly predicts new-onset ischemic stroke, MI, cardiovascular death, and combined cardiovascular endpoint including CHF in coronary patients or risk equivalent. Adverse vascular function may implicate an intermediate pathophysiological phenotype or mediating mechanism.
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