TY - JOUR T1 - Predicting sudden cardiac death in a general population using an electrocardiographic risk score JF - Heart JO - Heart SP - 427 LP - 433 DO - 10.1136/heartjnl-2019-315437 VL - 106 IS - 6 AU - Arttu Holkeri AU - Antti Eranti AU - M Anette E Haukilahti AU - Tuomas Kerola AU - Tuomas V Kenttä AU - Jani T Tikkanen AU - Olli Anttonen AU - Kai Noponen AU - Tapio Seppänen AU - Harri Rissanen AU - Markku Heliövaara AU - Paul Knekt AU - M Juhani Junttila AU - Heikki V Huikuri AU - Aapo L Aro Y1 - 2020/03/01 UR - http://heart.bmj.com/content/106/6/427.abstract N2 - Objective We investigated whether combining several ECG abnormalities would identify general population subjects with a high sudden cardiac death (SCD) risk.Methods In a sample of 6830 participants (mean age 51.2±13.9 years; 45.5% male) in the Mini-Finland Health Survey, a general population cohort representative of the Finnish adults aged ≥30 years conducted in 1978–1980, we examined their ECGs, following subjects for 24.3±10.4 years. We analysed the association between individual ECG abnormalities and 10-year SCD risk and developed a risk score using five ECG abnormalities independently associated with SCD risk: heart rate >80 beats per minute, PR duration >220 ms, QRS duration >110 ms, left ventricular hypertrophy and T-wave inversion. We validated the score using an external general population cohort of 10 617 subjects (mean age 44.0±8.5 years; 52.7% male).Results No ECG abnormalities were present in 4563 subjects (66.8%), while 96 subjects (1.4%) had ≥3 ECG abnormalities. After adjusting for clinical factors, the SCD risk increased progressively with each additional ECG abnormality. Subjects with ≥3 ECG abnormalities had an HR of 10.23 (95% CI 5.29 to 19.80) for SCD compared with those without abnormalities. The risk score similarly predicted SCD risk in the validation cohort, in which subjects with ≥3 ECG abnormalities had HR 10.82 (95% CI 3.23 to 36.25) for SCD compared with those without abnormalities.Conclusion The ECG risk score successfully identified general population subjects with a high SCD risk. Combining ECG risk markers may improve the risk stratification for SCD. ER -