RT Journal Article
SR Electronic
T1 Prognostic value of electrocardiographic abnormalities in adults from the Brazilian longitudinal study of adults’ health
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1560
OP 1566
DO 10.1136/heartjnl-2020-318097
VO 107
IS 19
A1 Marcelo Martins Pinto-Filho
A1 Luisa Caldeira Brant
A1 Rodrigo Padilha dos Reis
A1 Luana Giatti
A1 Bruce Bartholow Duncan
A1 Paulo A Lotufo
A1 Maria de Jesus M da Fonseca
A1 Jose Geraldo Mill
A1 Maria da Conceição Chagas de Almeida
A1 Peter MacFarlane
A1 Sandhi Maria Barreto
A1 Antonio Luiz Pinho Ribeiro
YR 2021
UL http://heart.bmj.com/content/107/19/1560.abstract
AB Objective Cardiovascular diseases (CVDs) are highly preventable non-communicable diseases. ECG is a potential tool for risk stratification with respect to CVD. Our aim was to evaluate ECG’s role in all-cause and cardiovascular mortality prediction.Methods Participants from the Brazilian Longitudinal Study of Adult Health, free of known CVD at baseline were included. A 12-lead ECG was obtained at baseline (2008–2010). Participants were followed up to 2018 by annual interviews. Deaths were independently reviewed. Cox as well as Fine and Grey multivariable regression models were applied to evaluate if the presence of any major electrocardiographic abnormality (MEA), defined according to the Minnesota Code system, would predict total and cardiovascular deaths. We also evaluated the Net Reclassification Index of adding MEA to the Systematic Coronary Risk Evaluation (SCORE).Results The 13 428 participants (median age 51 years, 45% men) were followed up for 8±1 years. All-cause and cardiovascular mortality occurred in 2.8% and 1.2% of the population, respectively. Prevalent MEA was an independent predictor of overall (HR=2.3, 95% CI 1.7 to 2.9) and cardiovascular mortality (HR=4.6, 95% CI 3.0 to 7.0) after adjustments for age, race, education and traditional cardiovascular risk factors. Adding MEA to the SCORE resulted in 9% mis-reclassification in the non-event subgroup and 33% correct reclassification in those with a fatal cardiovascular event.Conclusion Presence of MEA was an independent predictor of overall and cardiovascular mortality. ECG may have a role in risk prediction of cardiovascular mortality in primary care.All data relevant to the study are included in the article or uploaded as supplementary information. All relevant data were included. All data are available.