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Electrocardiogram abnormalities and cardiovascular mortality in elderly patients with CKD

Mirela Dobre1, Andrei Brateanu, Arash Rashidi

  • 1Division of Nephrology and Hypertension, Case Western Reserve University, Cleveland, Ohio, USA. mirela.dobre@uhhospitals.org

Clinical Journal of the American Society of Nephrology : CJASN
|March 31, 2012
PubMed

Insights

Major electrocardiogram (ECG) abnormalities are common in chronic kidney disease (CKD) and significantly increase the risk of cardiovascular death. Early identification of these ECG changes is crucial for managing cardiovascular risk in CKD patients.

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.
Abstract

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