Prevalence and Clinical Impact of Electrocardiographic Abnormalities in Patients with Chronic Kidney Disease
Chronic kidney disease (CKD) is a strong risk factor for cardiovascular disease. An electrocardiogram (ECG) is a basic test for screening cardiovascular disease. However, the impact of ECG abnormalities on cardiovascular prognosis in patients with CKD is largely unknown. A total of 2442 patients wit...
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MDPI AG
2022-09-01
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| author | Sejun Park Yunjin Yum Jung-Joon Cha Hyung Joon Joo Jae Hyoung Park Soon Jun Hong Cheol Woong Yu Do-Sun Lim |
| author_facet | Sejun Park Yunjin Yum Jung-Joon Cha Hyung Joon Joo Jae Hyoung Park Soon Jun Hong Cheol Woong Yu Do-Sun Lim |
| author_sort | Sejun Park |
| collection | DOAJ |
| description | Chronic kidney disease (CKD) is a strong risk factor for cardiovascular disease. An electrocardiogram (ECG) is a basic test for screening cardiovascular disease. However, the impact of ECG abnormalities on cardiovascular prognosis in patients with CKD is largely unknown. A total of 2442 patients with CKD (stages 3–5) who underwent ECG between 2013 and 2015 were selected from the electronic health record database of the Korea University Anam Hospital. ECG abnormalities were defined using the Minnesota classification. The five-year major adverse cerebrocardiovascular event (MACCE), the composite of death, myocardial infarction (MI), and stroke were analyzed. The five-year incidences for MACCE were 27.7%, 20.8%, and 17.2% in patients with no, minor, and major ECG abnormality (<i>p</i> < 0.01). Kaplan–Meier curves also showed the highest incidence of MI, death, and MACCE in patients with major ECG abnormality. Multivariable Cox regression analysis revealed age, sex, diabetes, CKD stage, hsCRP, antipsychotic use, and major ECG abnormality as independent risk predictors for MACCE (adjusted HR of major ECG abnormality: 1.39, 95% CI: 1.09–1.76, <i>p</i> < 01). Among the detailed ECG diagnoses, sinus tachycardia, myocardial ischemia, atrial premature complex, and right axis deviation were proposed as important ECG diagnoses. The accuracy of cardiovascular risk stratification was improved when the ECG results were added to the conventional SCORE model (net reclassification index 0.07). ECG helps to predict future cerebrocardiovascular events in CKD patients. ECG diagnosis can be useful for cardiovascular risk evaluation in CKD patients when applied in addition to the conventional risk stratification model. |
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| language | English |
| last_indexed | 2024-03-09T23:36:32Z |
| publishDate | 2022-09-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-e90e31248c664bb98b21c765b73d0cb02023-11-23T17:00:20ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011118541410.3390/jcm11185414Prevalence and Clinical Impact of Electrocardiographic Abnormalities in Patients with Chronic Kidney DiseaseSejun Park0Yunjin Yum1Jung-Joon Cha2Hyung Joon Joo3Jae Hyoung Park4Soon Jun Hong5Cheol Woong Yu6Do-Sun Lim7Department of Internal Medicine, Korea University Anam Hospital, Seoul 02841, KoreaDepartment of Biostatistics, Korea University College of Medicine, Seoul 02841, KoreaDepartment of Internal Medicine, Division of Cardiology, Korea University Anam Hospital, Seoul 02841, KoreaDepartment of Internal Medicine, Division of Cardiology, Korea University Anam Hospital, Seoul 02841, KoreaDepartment of Internal Medicine, Division of Cardiology, Korea University Anam Hospital, Seoul 02841, KoreaDepartment of Internal Medicine, Division of Cardiology, Korea University Anam Hospital, Seoul 02841, KoreaDepartment of Internal Medicine, Division of Cardiology, Korea University Anam Hospital, Seoul 02841, KoreaDepartment of Internal Medicine, Division of Cardiology, Korea University Anam Hospital, Seoul 02841, KoreaChronic kidney disease (CKD) is a strong risk factor for cardiovascular disease. An electrocardiogram (ECG) is a basic test for screening cardiovascular disease. However, the impact of ECG abnormalities on cardiovascular prognosis in patients with CKD is largely unknown. A total of 2442 patients with CKD (stages 3–5) who underwent ECG between 2013 and 2015 were selected from the electronic health record database of the Korea University Anam Hospital. ECG abnormalities were defined using the Minnesota classification. The five-year major adverse cerebrocardiovascular event (MACCE), the composite of death, myocardial infarction (MI), and stroke were analyzed. The five-year incidences for MACCE were 27.7%, 20.8%, and 17.2% in patients with no, minor, and major ECG abnormality (<i>p</i> < 0.01). Kaplan–Meier curves also showed the highest incidence of MI, death, and MACCE in patients with major ECG abnormality. Multivariable Cox regression analysis revealed age, sex, diabetes, CKD stage, hsCRP, antipsychotic use, and major ECG abnormality as independent risk predictors for MACCE (adjusted HR of major ECG abnormality: 1.39, 95% CI: 1.09–1.76, <i>p</i> < 01). Among the detailed ECG diagnoses, sinus tachycardia, myocardial ischemia, atrial premature complex, and right axis deviation were proposed as important ECG diagnoses. The accuracy of cardiovascular risk stratification was improved when the ECG results were added to the conventional SCORE model (net reclassification index 0.07). ECG helps to predict future cerebrocardiovascular events in CKD patients. ECG diagnosis can be useful for cardiovascular risk evaluation in CKD patients when applied in addition to the conventional risk stratification model.https://www.mdpi.com/2077-0383/11/18/5414electrocardiogramchronic kidney diseasemajor adverse cerebrocardiovascular events |
| spellingShingle | Sejun Park Yunjin Yum Jung-Joon Cha Hyung Joon Joo Jae Hyoung Park Soon Jun Hong Cheol Woong Yu Do-Sun Lim Prevalence and Clinical Impact of Electrocardiographic Abnormalities in Patients with Chronic Kidney Disease Journal of Clinical Medicine electrocardiogram chronic kidney disease major adverse cerebrocardiovascular events |
| title | Prevalence and Clinical Impact of Electrocardiographic Abnormalities in Patients with Chronic Kidney Disease |
| title_full | Prevalence and Clinical Impact of Electrocardiographic Abnormalities in Patients with Chronic Kidney Disease |
| title_fullStr | Prevalence and Clinical Impact of Electrocardiographic Abnormalities in Patients with Chronic Kidney Disease |
| title_full_unstemmed | Prevalence and Clinical Impact of Electrocardiographic Abnormalities in Patients with Chronic Kidney Disease |
| title_short | Prevalence and Clinical Impact of Electrocardiographic Abnormalities in Patients with Chronic Kidney Disease |
| title_sort | prevalence and clinical impact of electrocardiographic abnormalities in patients with chronic kidney disease |
| topic | electrocardiogram chronic kidney disease major adverse cerebrocardiovascular events |
| url | https://www.mdpi.com/2077-0383/11/18/5414 |
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