Key result
High ECG risk score linked to ~75% higher prevalence of elevated CAC vs. zero score.
Why the study?
Integrated abnormal ECG parameters predict CVD risk, but their relationship with subclinical CVD is unknown.
Does an integrated electrocardiogram risk score predict the prevalence of coronary artery calcium in asymptomatic adults?
Cross-Sectional (n=134,802)
Yes
Does an integrated electrocardiogram risk score predict the prevalence of coronary artery calcium in asymptomatic adults?
Effect estimate: PR 1.75 (95% CI 1.33-2.29)
An integrated ECG risk score may serve as a useful non-invasive screening tool to identify subclinical atherosclerosis in young, low-risk populations who might benefit from lipid-lowering therapy.
ECG score ≥3 associated with higher CAC prevalence; hypothesis-generating for subclinical atherosclerosis screening, requiring prospective validation before clinical use.
Integrated abnormal electrocardiogram (ECG) parameters predict the risk of cardiovascular disease (CVD); however, its relationship with subclinical CVD is unknown. We aimed to evaluate the association between the integrated ECG risk score and the prevalence of coronary artery calcium (CAC). A cross-sectional study comprised 134,802 participants with no known CVD who underwent ECG and CAC computed tomography. The ECG risk score was the sum of five ECG abnormalities: heart rate of >80 beats, QRS of >110 ms, left ventricular hypertrophy, T-wave inversion, and prolonged QTc. A multinomial regression model was used to estimate the prevalence ratios (PRs) and their 95% confidence intervals (CIs) for prevalent CAC. The prevalence of CAC progressively increased as the ECG risk score increased. After adjustment for conventional CVD risk factors and other confounders, the multivariable-adjusted PRs (95% CI) for a CAC of 1−100 in the 1, 2, and ≥3 ECG risk score groups were 1.06 (1.02−1.10), 1.12 (1.03−1.22), and 1.19 (1.00−1.42), respectively, while the corresponding PRs for a CAC of >100 were 1.03 (0.95−1.12), 1.44 (1.25−1.66), and 1.75 (1.33−2.29), respectively. Integrative ECG scoring may help identify individuals requiring lipid-lowering medications, even in young and asymptomatic populations.
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Kang et al. (2022) conducted a cross-sectional in Subclinical atherosclerosis (No known CVD) (n=134,802). Integrated ECG risk score ≥3 vs. ECG risk score of 0 was evaluated on Prevalence of coronary artery calcium (CAC) > 100 (PR 1.75, 95% CI 1.33-2.29). An integrated ECG risk score of ≥3 abnormalities was associated with a higher prevalence of coronary artery calcium >100 compared to a score of 0 (PR 1.75, 95% CI 1.33-2.29).
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