Electrocardiographic Changes Improve Risk Prediction in Asymptomatic Persons Age 65 Years or Above Without Cardiovascular Disease
Autor: | Gorm B. Jensen, Jan Skov Jensen, Rasmus Mogelvang, M Appleyard, Peter Godsk Jørgensen, Jacob Louis Marott |
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Rok vydání: | 2014 |
Předmět: |
Male
medicine.medical_specialty Time Factors electrocardiography Population Left ventricular hypertrophy Risk Assessment elderly Asymptomatic Cohort Studies risk prediction Risk Factors Internal medicine medicine Clinical endpoint Humans Registries cardiovascular diseases skin and connective tissue diseases education Depression (differential diagnoses) Aged Aged 80 and over education.field_of_study medicine.diagnostic_test business.industry Hazard ratio Prognosis medicine.disease Confidence interval Surgery Treatment Outcome Cardiovascular Diseases Cardiology Female Hypertrophy Left Ventricular sense organs medicine.symptom Cardiology and Cardiovascular Medicine business Electrocardiography Follow-Up Studies |
Zdroj: | Journal of the American College of Cardiology. 64:898-906 |
ISSN: | 0735-1097 |
Popis: | BackgroundRisk prediction in elderly patients is increasingly relevant due to longer life expectancy.ObjectivesThis study sought to examine whether electrocardiographic (ECG) changes provide prognostic information incremental to current risk models and to the conventional risk factors.MethodsIn all, 6,991 participants from the Copenhagen Heart Study attending an examination at age ≥65 years were included. ECG changes were defined as Q waves, ST-segment depression, T-wave changes, ventricular conduction defects, and left ventricular hypertrophy based on the Minnesota code. The primary endpoint was fatal cardiovascular disease (CVD) event and the secondary was fatal or nonfatal CVD event. In our study, 2,236 fatal CVD and 3,849 fatal or nonfatal CVD events occurred during a median of 11.9 and 9.8 years of follow-up.ResultsECG changes were frequently present (30.6%) and associated with conventional risk factors. All ECG changes except 1 univariably predicted both endpoints. Event rates of ECG changes versus no ECG changes were respectively 41.4% versus 27.8% and 64.6% versus 50.8%. When added to existing risk scores, ECG changes independently increased the risk of both endpoints. Fatal CVD events: hazard ratio (HR): 1.33 (95% confidence interval [CI]: 1.29 to 1.36; p |
Databáze: | OpenAIRE |
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