A large frontal QRS-T angle is a strong predictor of the long-term risk of myocardial infarction and all-cause mortality in the diabetic population.
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/METHODS 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).