Prognostic value of the computerized ECG in Hispanics.

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Limited data exists on electrocardiogram (ECG) abnormality prevalence and prognostic value in Hispanic populations compared to other ethnicities.
• Hispanics exhibit a worse cardiovascular risk profile but paradoxically lower cardiovascular disease prevalence.

Purpose of the Study:

• To investigate the hypothesis that ECG abnormalities are less common in Hispanics.
• To determine if ECG abnormalities are less strongly associated with cardiovascular mortality in Hispanics.

Main Methods:

• Analysis of 45,563 ECGs from a Veteran's hospital, excluding patients deceased within one week of ECG.
• Demographic data collection and an average 7.5-year follow-up using the California Death Index.
• Utilized GE/Marquette computerized ECG system for characteristic analysis and performed age, sex, and heart rate-adjusted Cox hazard ratio analyses.

Main Results:

• Hispanic ethnicity was associated with lower cardiovascular death (HR 0.76).
• Atrial fibrillation, Q-waves, left ventricular hypertrophy (LVH), and specific T-wave findings were less prevalent in Hispanics.
• These ECG abnormalities showed similar increased cardiovascular mortality risk (HR ~2) in both Hispanic and non-Hispanic groups.

Conclusions:

• Lower prevalence of ECG markers for coronary heart disease, atrial fibrillation, and LVH in Hispanics supports observations of lower cardiovascular disease prevalence.
• Despite lower prevalence, ECG abnormalities are similarly associated with increased mortality in both Hispanic and non-Hispanic individuals.