Association of major and minor ECG abnormalities with coronary heart disease events

Area of Science:

• Cardiology
• Geriatric Medicine
• Preventive Cardiology

Background:

• Traditional risk factors for coronary heart disease (CHD) are less accurate in predicting events in older adults.
• Electrocardiogram (ECG) abnormalities are common in this demographic and may offer additional predictive value.
• The Health, Aging, and Body Composition (Health ABC) Study provides a robust dataset for investigating this association.

Purpose of the Study:

• To assess if baseline ECG abnormalities are linked to increased CHD events in older adults.
• To determine if the development of new or persistent ECG abnormalities over time predicts future CHD events.
• To evaluate the added value of ECG abnormalities in CHD risk prediction models.

Main Methods:

• A population-based cohort of 2192 older adults (70-79 years) without prior cardiovascular disease was studied.
• Baseline and 4-year ECGs were analyzed for major and minor abnormalities using the Minnesota Code.
• Cox proportional hazards regression models were used to assess the association between ECG abnormalities and adjudicated CHD events over 8 years.

Main Results:

• At baseline, 13% had minor and 23% had major ECG abnormalities. Both were associated with increased CHD risk (HR 1.35 and 1.51, respectively).
• New and persistent ECG abnormalities after 4 years also significantly predicted subsequent CHD events (HR 2.01 and 1.66, respectively).
• Adding ECG abnormalities to traditional risk factors improved CHD risk reclassification in intermediate-risk individuals.

Conclusions:

• Both baseline and evolving ECG abnormalities are significant predictors of CHD events in older adults.
• ECG analysis provides valuable information for refining CHD risk prediction beyond established risk factors in this population.
• These findings support the routine use of ECGs in assessing cardiovascular risk in older individuals.