Electrocardiogram abnormalities and cardiovascular mortality in elderly patients with CKD

Area of Science:

• Cardiology
• Nephrology
• Medical Diagnostics

Background:

• Cardiovascular disease (CVD) is the leading cause of mortality in patients with chronic kidney disease (CKD).
• Electrocardiogram (ECG) abnormalities are frequently observed in CKD patients but their predictive value for cardiovascular outcomes requires further evaluation.

Purpose of the Study:

• To investigate whether electrocardiogram (ECG) abnormalities predict cardiovascular death in individuals with chronic kidney disease (CKD).

Main Methods:

• Utilized the Cardiovascular Health Study limited database (1989-2005) to identify a cohort with CKD (estimated GFR < 60 mL/min per 1.73 m²).
• Categorized participants into major, minor, or no ECG abnormalities groups.
• Employed proportional hazards regression models to compare rates of cardiovascular events and mortality among the groups.

Main Results:

• A cohort of 1192 CKD participants (mean age 74.7 years) was analyzed; 38.8% had major, 29.7% minor, and 31.5% no ECG abnormalities.
• CKD patients were more likely to exhibit ECG abnormalities at baseline (aOR, 1.23).
• During follow-up (10.3 years), participants with major ECG abnormalities showed a significantly higher risk for cardiovascular events (aHR, 2.15) and death (aHR, 2.27) compared to those without abnormalities. Minor abnormalities also showed an increased risk (aHR for death, 1.48).

Conclusions:

• Major ECG abnormalities are prevalent in patients with CKD.
• These major ECG abnormalities serve as significant predictors of increased mortality and adverse cardiovascular outcomes in the CKD population.