Key result
Having two or more non-specific ECG abnormalities significantly increased the risk of cardiovascular death in healthy individuals after adjustment for Framingham risk score (HR 4.27 in men, HR 4.83 in women).
Why the study?
Do cumulative non-specific 12-lead ECG abnormalities predict cardiovascular death in healthy individuals independent of traditional risk scores?
Cohort (n=16,816)
Yes
Do cumulative non-specific 12-lead ECG abnormalities predict cardiovascular death in healthy individuals independent of traditional risk scores?
Hazard Ratio: 4.27 (95% CI 3.35–5.45)
p-value: p=<0.001
Cumulative non-specific 12-lead ECG abnormalities independently predict long-term cardiovascular death in asymptomatic, healthy individuals, adding prognostic value beyond traditional risk scores.
May refine CV risk stratification beyond Framingham/NIPPON scores; leaves open whether ECG findings should guide interventions.
AIMS: The long-term prognostic effect of non-specific 12-lead electrocardiogram findings is unknown. We aimed to evaluate the cumulative prognostic impact of axial, structural, and repolarization categorical abnormalities on cardiovascular death, independent from traditional risk scoring systems such as the Framingham risk score and the NIPPON DATA80 risk chart. METHODS AND RESULTS: A total of 16,816 healthy men and women from two prospective, longitudinal cohort studies were evaluated. 3,794 (22.6%) individuals died during a median follow-up of 15 years (range, 2.0-24 years). Hazard ratios for cardiovascular death, all-cause death, coronary death and stroke death were calculated for the cumulative and independent axial, structural, and repolarization categorical abnormalities adjusted for the Framingham risk score and the NIPPON DATA80 risk chart. Individuals with two or more abnormal categories had a higher risk of cardiovascular death after adjustment for Framingham risk score (men: HR 4.27, 95%CI 3.35-5.45; women: HR 4.83, 95%CI 3.76-6.22) and NIPPON DATA80 risk chart (men: HR 2.39, 95%CI 1.87-3.07; women: HR 2.04, 95%CI 1.58-2.64). CONCLUSION: Cumulative findings of axial, structural, and repolarization abnormalities are significant predictors of long-term cardiovascular death in asymptomatic, healthy individuals independent of traditional risk stratification systems.
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Sawano et al. (2016) conducted a cohort in Healthy, asymptomatic individuals (n=16,816). Two or more non-specific ECG abnormalities vs. No ECG abnormalities was evaluated on Cardiovascular death (men, ≥2 abnormal ECG categories vs none, FRS adjusted) (HR 4.27, 95% CI 3.35-5.45, p=<0.001). Having two or more non-specific ECG abnormalities significantly increased the risk of cardiovascular death in healthy individuals after adjustment for Framingham risk score (HR 4.27 in men, HR 4.83 in women).
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