Abstract 9156: P-Wave Axis is an Independent Predictor of Mortality in Type II Diabetes Mellitus: The Diabetes Heart Study

Abstract

Introduction: Abnormal P-wave axis (PWA) has been associated with an increased risk of all-cause and cardiovascular mortality in various populations. However, the correlation of this prognostic indicator with mortality has not been systematically studied in patients with type II diabetes mellitus (T2DM) over a long-term period. The aim of this study was to investigate the association between abnormal PWA and all-cause mortality in participants from the Diabetes Heart Study (DHS). Methods: Out of the 1,443 participants in the DHS, 1,101 participants with T2DM and PWA data from electrocardiogram were included in the analysis. Kaplan-Meier (KM) and Cox proportional hazards models were used to analyze the association between PWA and mortality, adjusting for demographics and other potential confounding variables. Results: 85 of the 1,101 participants (7.7%) had abnormal PWA. The mean age of all participants was 61.8 ± 8.9 years, with 45.7% of participants being male. Over a mean follow-up of 12.1 ± 4.4 years, a total of 504 deaths (45.8%) occurred. KM analysis showed that participants with abnormal PWA had a significantly higher rate of death than those with normal PWA (Log-Rank p<0.0001). Abnormal PWA was associated with increased risk of mortality (HR: 1.75, 95% CI: 1.31-2.29). After multivariable adjustment, the association remained significant (HR: 1.55, 95% CI: 1.14-2.06). Interaction analysis demonstrated a significant interaction between race and PWA group (p=0.03). Subgroup analysis showed increased risk of mortality with abnormal PWA in white participants, but no significant association between mortality and abnormal PWA in black participants (p=0.81). Conclusions: Abnormal PWA is independently associated with increased risk of mortality in a cohort of participants with T2DM. Further research on the association between race, PWA, and mortality risk is warranted. PWA may serve as an independent prognostic indicator of mortality risk in patients with T2DM.