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A New 12-Lead ECG Prognostic Score
Muhammad Soofi1, Nikhil A Jain2, Jonathan Myers2,3
1Ohio State University, College of Medicine, Columbus, OH.
Background:
The Diagonal Line Rule (DLR) is an educational pattern recognition tool for the classification of 12-lead electrocardiograms (ECGs) as normal or abnormal.
Objective:
To develop a score using the DLR for the risk stratification of abnormal ECGs.
Methods:
Patients at the Palo Alto, VA, referred for a routine resting ECG between 1987 and 1999 were retrospectively considered. The initial ECGs of 43,798 patients were scored according to the DLR. The main outcome variable was cardiovascular mortality with 8 years of follow-up.
Results:
ECG abnormalities identified by the DLR were combined with age, gender, and ST depression to develop an additive score. The score was validated and shown to stratify levels of cardiac risk with a 0.78 area under the receiver operating characteristic (ROC) curve for identifying those who had a cardiovascular death.
Conclusion:
The score effectively stratifies ECGs for prediction of risk of cardiovascular death.
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