Mortality in Relation to Minnesota Code Items in Elderly Subjects. Sex-Related Differences in a Cardiovascular Study in the Elderly.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Elderly general population (n=2254). Intervention: Minnesota code ECG abnormalities (e.g., ischaemia, bundle branch blocks, AV block) vs. Absence of specific ECG abnormalities. Primary outcome: Overall mortality.

Edoardo Casiglia; Paolo Spolaore; G Ginocchio; M. Marchioro; Alberto Mazza; Giuseppe Di Menza; Giorgia Maniati; Cosmas Daskalakis; G Colangeli; Giovanni B. Ambrosio

doi:10.1536/ihj.34.567

January 1, 1993Japanese Heart JournalOpen Access

Mortality in Relation to Minnesota Code Items in Elderly Subjects. Sex-Related Differences in a Cardiovascular Study in the Elderly.

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Key result

Minnesota code ECG abnormalities, including ischaemia, 1st-degree atrio-ventricular block, and bundle branch blocks, were significant independent predictors of overall mortality in elderly subjects.

Why the study?

Do specific Minnesota code ECG abnormalities predict overall and cardiovascular mortality in an elderly general population?

Key Points

This research aims to explore the prognostic significance of electrocardiographic abnormalities in predicting mortality among elderly subjects.
Examined Minnesota code ECG items in 2254 elderly subjects from the Cardiovascular Study in the Elderly (CASTEL).
Analyzed predictors of overall and cardiovascular mortality in relation to ECG abnormalities differentiated by sex.
Ischaemia, 1st-degree atrio-ventricular block, and bundle branch blocks were significant mortality predictors in females.
Ischaemia, left bundle branch block, and atrial fibrillation predicted cardiovascular mortality in both sexes; right bundle branch block was significant in men only.
1st-degree atrio-ventricular block was a predictor in women only, while left anterior haemiblock and bifascicular blocks showed no predictive value.

Study Design

Type

Cohort (n=2,254)

Multicenter

No

Structured PICO

Do specific Minnesota code ECG abnormalities predict overall and cardiovascular mortality in an elderly general population?

P

Population

2,254 elderly subjects (63.7% female) from a general population in Northern Italy, followed for 7 years to evaluate the prognostic value of Minnesota code ECG abnormalities.

E

Exposure

Presence of specific Minnesota code ECG abnormalities (e.g., ischaemia, bundle branch blocks, myocardial infarction, atrial fibrillation, left ventricular hypertrophy)

C

Comparator

Absence of the respective Minnesota code ECG abnormalities

O

Outcome

Overall mortality and cardiovascular mortality at 7 yearshard clinical

Specific Minnesota code ECG abnormalities, such as ischaemia and bundle branch blocks, are significant predictors of mortality in the elderly, with notable sex-related differences.

Limitations

Standard ECG has low sensitivity for identifying left ventricular hypertrophy in the elderly compared to echocardiography.
Minor ventricular ectopic events were too rare for statistical analysis and were excluded.
Major ventricular arrhythmias were not screened.
Minor ventricular ectopic events were not taken into consideration because they were too rare for any statistical analysis
ECG is not very sensible for identifying LVH, especially in the elderly

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Implication

ECG abnormalities may signal higher mortality risk in elderly women; leaves open utility for sex-specific risk stratification.

Abstract

The prognostic value of electrocardiographic abnormalities has not been widely studied in the elderly. We examined the Minnesota code ECG items in 2254 elderly subjects of the Cardiovascular Study in the Elderly (CASTEL), performed on an Italian general population. In our experience, codes for ischaemia, 1st-degree atrio-ventricular block, bundle branch blocks, myocardial infarction, atrial fibrillation or sinus tachycardia were predictors of overall mortality in females, while only the former three items were predictors in men. Although ischaemia, left bundle branch block and atrial fibrillation were predictors of cardiovascular mortality in both sexes, right bundle branch block, supraventricular arrhythmias and left ventricular hypertrophy were predictors only in men, and 1st-degree atrio-ventricular block were predictors only in women. Surprisingly, left anterior haemiblock and bifascicular blocks were not predictive of mortality.

Discussion

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Cite This Study

Casiglia et al. (1993) conducted a cohort in Elderly general population (n=2,254). Minnesota code ECG abnormalities (e.g., ischaemia, bundle branch blocks, AV block) vs. Absence of specific ECG abnormalities was evaluated on Overall mortality. Minnesota code ECG abnormalities, including ischaemia, 1st-degree atrio-ventricular block, and bundle branch blocks, were significant independent predictors of overall mortality in elderly subjects.

synapsesocial.com/papers/6a6d53758031ec7bb1db5af7 https://doi.org/10.1536/ihj.34.567

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Mortality in Relation to Minnesota Code Items in Elderly Subjects. Sex-Related Differences in a Cardiovascular Study in the Elderly.

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Mortality in Relation to Minnesota Code Items in Elderly Subjects. Sex-Related Differences in a Cardiovascular Study in the Elderly.

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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