Key result
In outpatients with extracardiac artery disease, major ECG abnormalities were significantly associated with an increased risk of cardiovascular events (HR 1.58; 95% CI 1.11-2.25; P=0.012).
Why the study?
Do resting ECG abnormalities predict cardiovascular events in outpatients with extracardiac artery disease?
Cohort (n=832)
Do resting ECG abnormalities predict cardiovascular events in outpatients with extracardiac artery disease?
Hazard Ratio: 1.58 (95% CI 1.11–2.25)
p-value: p=0.012
Resting ECG abnormalities are common in outpatients with extracardiac artery disease and serve as independent predictors of future cardiovascular events, suggesting utility in risk stratification.
Major ECG abnormalities may aid risk stratification in extracardiac artery disease outpatients; hypothesis-generating and requires prospective validation.
Identifying cardiac disease in patients with extracardiac artery disease (ECAD) is essential for clinical decision-making. Electrocardiography (ECG) is an easily accessible tool to unmask subclinical cardiac disease and to risk stratify patient with or without manifest cardiovascular disease (CV). We aimed to examine the prevalence and prognostic impact of ECG changes in outpatients with ECAD. Outpatients with carotid or lower extremity artery disease (n = 435) and community-based controls (n = 397) underwent resting ECG. The patients were followed during a median of 4·8 years for CV events (hospitalization or death caused by ischaemic heart disease, cardiac arrest, heart failure, or stroke). ECG abnormalities were classified according to the Minnesota Code. Major (33% versus 15%, P<0·001) but not minor ECG abnormalities (23% versus 26%, P = 0·42) were significantly more common in patients versus controls. During the follow-up, 141 patients experienced CV events. Both major ECG abnormalities [hazard ratio (HR) 1·58, 95% confidence interval (CI) 1·11-2·25, P = 0·012] and any ECG abnormalities (HR 1·57, 95% CI 1·06-2·33, P = 0·024) were significantly associated with CV events after adjustment for potential risk factors. In conclusion, ECG abnormalities were common in these outpatients with ECAD. Major and any ECG abnormalities were independent predictors of CV events. Addition of easily accessible ECG information might be useful in risk stratification for such patients.
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Hysing et al. (2017) conducted a cohort in Extracardiac artery disease (n=832). Major ECG abnormalities vs. Absence of major ECG abnormalities was evaluated on CV events (hospitalization or death caused by ischaemic heart disease, cardiac arrest, heart failure, or stroke) (HR 1.58, 95% CI 1.11-2.25, p=0.012). In outpatients with extracardiac artery disease, major ECG abnormalities were significantly associated with an increased risk of cardiovascular events (HR 1.58; 95% CI 1.11-2.25; P=0.012).
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