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Medical Science Monitor Basic Research


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A planar QRS-T angle >90 degrees is associated with multivessel coronary artery disease in patients undergoing coronary angiography

Chandrasekar Palaniswamy, Tarunjit Singh, Wilbert S Aronow, Chul Ahn, Kumar Kalapatapu, Melvin B. Weiss, Anthony L. Pucillo, Craig E. Monsen

Med Sci Monit 2009; 15(12): MS31-34

ID: 878264

Background: The aim of the study was to investigate the severity of coronary artery disease (CAD) in patients who had a planar QRS-T angle >90 degrees versus <or=90 degrees.
Material and Method: Coronary angiography was performed in 1,229 consecutive patients. Obstructive CAD was diagnosed if there was >50% obstruction of >or=1 major coronary artery. All QRS-T angle measurements were made from a 12-lead electrocardiogram by 2 authors who agreed on the measurement and who were blinded to the coronary angiographic findings. A QRS-T angle >90 degrees was considered abnormal.
Results: Obstructive CAD of 2 or 3 vessels was present in 309 of 495 patients (62%) with a planar QRS-T angle >90 degrees and in 250 of 734 patients (34%) with a planar QRS-T angle <or=90 degrees . (p<0.0001). Stepwise logistic regression analyses showed that significant independent risk factors for 2- or 3-vessel CAD were age (odds ratio =1.05), male gender (odds ratio =1.8), black race (odds ratio =0.34), unstable angina (odds ratio =0.16), positive stress test (odds ratio =3.0), hypertension (odds ratio =3.0), dyslipidemia (odds ratio =2.9), QRS-T angle (odds ratio =7.2), left bundle branch block (odds ratio =2.9), right bundle branch block (odds ratio =0.17), smoking (odds ratio =9.7), and body mass index >or=30 kg/m2 (odds ratio =1.5).
Conclusions: The prevalence of 2- or 3-vessel obstructive CAD was significantly higher in patients with a planar QRS-T angle >90 degrees than in patients with a planar QRS-T angle <or=90 degrees (p<0.0001).

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