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Electrocardiographic predictors of cardiovascular events in patients at high cardiovascular risk: a multicenter study

Rungroj Krittayaphong1, Muenpetch Muenkaew2, Polakit Chiewvit1

  • 1Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Journal of Geriatric Cardiology : JGC
|September 27, 2019
PubMed

Insights

Electrocardiogram (ECG) abnormalities are common in high-risk patients and predict major adverse cardiovascular events (MACE). Specific findings like atrial fibrillation and Q-waves significantly increase MACE risk.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Diagnostic Imaging

Background:

  • Limited data exist on electrocardiogram (ECG) abnormality prevalence and major adverse cardiovascular event (MACE) prediction in high-risk individuals.
  • This study addresses the need for data on ECG findings in patients with established atherosclerotic disease (EAD) or multiple risk factors (MRF).

Purpose of the Study:

  • To determine the prevalence of ECG abnormalities in patients at high cardiovascular risk.
  • To identify specific ECG abnormalities that predict MACE in this population.

Main Methods:

  • Consecutive enrollment of 2009 patients (≥45 years) with EAD or MRF from April 2011 to March 2014.
  • Data collection included demographics, risk factors, medical history, physical exam, ECG (Minnesota Code criteria), and medications.
  • MACE definition: cardiovascular death, non-fatal myocardial infarction, unstable angina, or heart failure hospitalization.

Main Results:

  • A high prevalence of ECG abnormalities was observed, including pathological Q-wave (21.3%), T-wave inversion (20.0%), left ventricular hypertrophy (12.2%), and AV block (12.5%).
  • MACE occurred in 4.4% of patients.
  • Independent MACE predictors included chronic kidney disease, EAD, and ECG findings of atrial fibrillation, Q/QS, intraventricular conduction delay (IVCD), or left ventricular hypertrophy (LVH).

Conclusions:

  • A high prevalence of ECG abnormalities exists in high-cardiovascular-risk patients, even those without diagnosed cardiovascular disease.
  • Specific ECG abnormalities are significant predictors of MACE, highlighting their prognostic value.
Abstract

Keywords:
Cardiovascular eventsElectrocardiographicHigh cardiovascular riskPredictors

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