Polyscore of autonomic parameters for risk stratification of the elderly general population: the Polyscore study
| Autor: | Katerina Hnatkova, Daniel Sinnecker, Alexander Hapfelmeier, Georg Schmidt, Alexander Müller, Othmar Gotzler, Alexander Steger, Petra Barthel, Marek Malik, Katharina M. Huster, Kurt Ulm, Teresa Gotzler, Michael Dommasch, Karl-Ludwig Laugwitz |
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| Přispěvatelé: | British Heart Foundation |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Population Myocardial Infarction 030204 cardiovascular system & hematology Autonomic Nervous System 03 medical and health sciences 0302 clinical medicine Framingham Heart Study Clinical Research Risk Factors Physiology (medical) Internal medicine medicine Clinical endpoint Humans Syncope and ILRs AcademicSubjects/MED00200 Prospective Studies 030212 general & internal medicine Myocardial infarction Elderly general population education Stroke Aged Risk assessment Autonomic markers education.field_of_study Framingham Risk Score business.industry Prospective validation 1103 Clinical Sciences Polyscore medicine.disease 3. Good health Cardiovascular System & Hematology Female Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | Europace |
| Popis: | Aims Present society is constantly ageing and elderly frequently suffer from conditions that are difficult and/or costly to treat if detected late. Effective screening of the elderly is therefore needed so that those requiring detailed clinical work-up are identified early. We present a prospective validation of a screening strategy based on a Polyscore of seven predominantly autonomic, non-invasive risk markers. Methods and results Within a population-based survey in Germany (INVADE study), participants aged ≥60 years were enrolled between August 2013 and February 2015. Seven prospectively defined Polyscore components were obtained during 30-min continuous recordings of electrocardiogram, blood pressure, and respiration. Out of 1956 subjects, 168 were excluded due to atrial fibrillation, implanted pacemaker, or unsuitable recordings. All-cause mortality over a median 4-year follow-up was prospectively defined as the primary endpoint. The Polyscore divided the investigated population (n = 1788, median age: 72 years, females: 58%) into three predefined groups with low (n = 1405, 78.6%), intermediate (n = 326, 18.2%), and high risk (n = 57, 3.2%). During the follow-up, 82 (4.6%) participants died. Mortality in the Polyscore-defined risk groups was 3.4%, 7.4%, and 17.5%, respectively (P Conclusion The Polyscore-based mortality risk assessment from short-term non-invasive recordings is effective in the elderly general population, especially those aged 60–74 years. Implementation of a comprehensive Polyscore screening of this age group is proposed to advance preventive medical care. |
| Databáze: | OpenAIRE |
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