Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease
Background: Abnormal 12‑lead electrocardiogram (ECG) findings and proposing its ability for enhanced risk prediction, majority of the studies have been carried out with elderly populations with prior cardiovascular diseases. This study aims to denote the association of sudden cardiac death (SCD) and...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-09-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906718300654 |
| _version_ | 1828769196187582464 |
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| author | Henri K. Terho Jani T. Tikkanen Tuomas V. Kenttä Juhani M. Junttila Aapo L. Aro Olli Anttonen Tuomas Kerola Harri A. Rissanen Paul Knekt Heikki V. Huikuri |
| author_facet | Henri K. Terho Jani T. Tikkanen Tuomas V. Kenttä Juhani M. Junttila Aapo L. Aro Olli Anttonen Tuomas Kerola Harri A. Rissanen Paul Knekt Heikki V. Huikuri |
| author_sort | Henri K. Terho |
| collection | DOAJ |
| description | Background: Abnormal 12‑lead electrocardiogram (ECG) findings and proposing its ability for enhanced risk prediction, majority of the studies have been carried out with elderly populations with prior cardiovascular diseases. This study aims to denote the association of sudden cardiac death (SCD) and various abnormal ECG morphologies using middle-aged population without a known cardiac disease. Methods: In total, 9511 middle-aged subjects (mean age 42 ± 8.2 years, 52% males) without a known cardiac disease were included in this study. Risk for SCD was assessed after 10 and 30-years of follow-up. Results: Abnormal ECG was present in 16.3% (N = 1548) of subjects. The incidence of SCD was distinctly higher among those with any ECG abnormality in 10 and 30-year follow-ups (1.7/1000 years vs. 0.6/1000 years, P < 0.001; 3.4/1000 years vs. 1.9/1000 years, P < 0.001). At 10-year point, competing risk multivariate regression model showed HR of 1.62 (95% CI 1.0–2.6, P = 0.05) for SCD in subjects with abnormal ECG. QRS duration ≥ 110 ms, QRST-angle > 100°, left ventricular hypertrophy, and T-wave inversions were the most significant independent ECG risk markers for 10-year SCD prediction with up to 3-fold risk for SCD. Those with ECG abnormalities had a 1.3-fold risk (95% CI 1.07–1.57, P = 0.007) for SCD in 30-year follow-up, whereas QRST-angle > 100°, LVH, ER ≥ 0.1 mV and ≥0.2 mV were the strongest individual predictors. Subjects with multiple ECG abnormalities had up to 6.6-fold risk for SCD (P < 0.001). Conclusion: Several ECG abnormalities are associated with the occurrence of early and late SCD events in the middle-age subjects without known history of cardiac disease. Keywords: Sudden cardiac death, Risk prediction, Electrocardiogram, Follow-up studies |
| first_indexed | 2024-12-11T13:43:33Z |
| format | Article |
| id | doaj.art-f16d26062a9f4f8fbc8f202ea313bfd9 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-12-11T13:43:33Z |
| publishDate | 2018-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-f16d26062a9f4f8fbc8f202ea313bfd92022-12-22T01:04:39ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672018-09-01205055Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac diseaseHenri K. Terho0Jani T. Tikkanen1Tuomas V. Kenttä2Juhani M. Junttila3Aapo L. Aro4Olli Anttonen5Tuomas Kerola6Harri A. Rissanen7Paul Knekt8Heikki V. Huikuri9Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Finland; Corresponding author at: Division of Cardiology, Medical Research Center Oulu, P.O Box 5000, Kajaanintie 50, FI-90014, University of Oulu, Finland.Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, FinlandMedical Research Center Oulu, Oulu University Hospital, and University of Oulu, FinlandMedical Research Center Oulu, Oulu University Hospital, and University of Oulu, FinlandHeart and Lung Center, Helsinki University Hospital, Helsinki, FinlandPäijät-Häme Central Hospital, Lahti, FinlandPäijät-Häme Central Hospital, Lahti, FinlandNational Institute of Health and Welfare, Helsinki, FinlandNational Institute of Health and Welfare, Helsinki, FinlandMedical Research Center Oulu, Oulu University Hospital, and University of Oulu, FinlandBackground: Abnormal 12‑lead electrocardiogram (ECG) findings and proposing its ability for enhanced risk prediction, majority of the studies have been carried out with elderly populations with prior cardiovascular diseases. This study aims to denote the association of sudden cardiac death (SCD) and various abnormal ECG morphologies using middle-aged population without a known cardiac disease. Methods: In total, 9511 middle-aged subjects (mean age 42 ± 8.2 years, 52% males) without a known cardiac disease were included in this study. Risk for SCD was assessed after 10 and 30-years of follow-up. Results: Abnormal ECG was present in 16.3% (N = 1548) of subjects. The incidence of SCD was distinctly higher among those with any ECG abnormality in 10 and 30-year follow-ups (1.7/1000 years vs. 0.6/1000 years, P < 0.001; 3.4/1000 years vs. 1.9/1000 years, P < 0.001). At 10-year point, competing risk multivariate regression model showed HR of 1.62 (95% CI 1.0–2.6, P = 0.05) for SCD in subjects with abnormal ECG. QRS duration ≥ 110 ms, QRST-angle > 100°, left ventricular hypertrophy, and T-wave inversions were the most significant independent ECG risk markers for 10-year SCD prediction with up to 3-fold risk for SCD. Those with ECG abnormalities had a 1.3-fold risk (95% CI 1.07–1.57, P = 0.007) for SCD in 30-year follow-up, whereas QRST-angle > 100°, LVH, ER ≥ 0.1 mV and ≥0.2 mV were the strongest individual predictors. Subjects with multiple ECG abnormalities had up to 6.6-fold risk for SCD (P < 0.001). Conclusion: Several ECG abnormalities are associated with the occurrence of early and late SCD events in the middle-age subjects without known history of cardiac disease. Keywords: Sudden cardiac death, Risk prediction, Electrocardiogram, Follow-up studieshttp://www.sciencedirect.com/science/article/pii/S2352906718300654 |
| spellingShingle | Henri K. Terho Jani T. Tikkanen Tuomas V. Kenttä Juhani M. Junttila Aapo L. Aro Olli Anttonen Tuomas Kerola Harri A. Rissanen Paul Knekt Heikki V. Huikuri Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease International Journal of Cardiology: Heart & Vasculature |
| title | Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease |
| title_full | Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease |
| title_fullStr | Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease |
| title_full_unstemmed | Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease |
| title_short | Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease |
| title_sort | electrocardiogram as a predictor of sudden cardiac death in middle aged subjects without a known cardiac disease |
| url | http://www.sciencedirect.com/science/article/pii/S2352906718300654 |
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