Association of electrocardiogram abnormalities and incident heart failure events.

TitleAssociation of electrocardiogram abnormalities and incident heart failure events.
Publication TypeJournal Article
Year of Publication2014
AuthorsGencer, B, Butler, J, Bauer, DC, Auer, R, Kalogeropoulos, A, Marques-Vidal, P, Applegate, W, Satterfield, S, Harris, T, Newman, A, Vittinghoff, E, Rodondi, N
Corporate AuthorsHealth ABC Study
JournalAmerican Heart Journal
Date Published06/2014
ISSN0002-8703 (linking)
ISBN Number1097-6744 (Electronic)
KeywordsAge Factors, Aged, Aged, 80 and over, Arrhythmias, Cardiac, Cohort Studies, Coronary Disease, Diabetes Mellitus, Electrocardiography, Female, Heart Failure, Humans, Hypertension, Incidence, Longitudinal Studies, Male, Proportional Hazards Models, Prospective Studies, Risk Assessment

UNLABELLED: Unless effective preventive strategies are implemented, aging of the population will result in a significant worsening of the heart failure (HF) epidemic. Few data exist on whether baseline electrocardiographic (ECG) abnormalities can refine risk prediction for HF.

METHODS: We examined a prospective cohort of 2,915 participants aged 70 to 79 years without preexisting HF, enrolled between April 1997 and June 1998 in the Health, Aging, and Body Composition (Health ABC) study. Minnesota Code was used to define major and minor ECG abnormalities at baseline and at year 4 follow-up. Using Cox models, we assessed (1) the association between ECG abnormalities and incident HF and (2) the incremental value of adding ECG to the Health ABC HF Risk Score using the net reclassification index.

RESULTS: At baseline, 380 participants (13.0%) had minor, and 620 (21.3%) had major ECG abnormalities. During a median follow-up of 11.4 years, 485 participants (16.6%) developed incident HF. After adjusting for the Health ABC HF Risk Score variables, the hazard ratio (HR) was 1.27 (95% CI 0.96-1.68) for minor and 1.99 (95% CI 1.61-2.44) for major ECG abnormalities. At year 4, 263 participants developed new and 549 had persistent abnormalities; both were associated with increased subsequent HF risk (HR 1.94, 95% CI 1.38-2.72 for new and HR 2.35, 95% CI 1.82-3.02 for persistent ECG abnormalities). Baseline ECG correctly reclassified 10.5% of patients with HF events, 0.8% of those without HF events, and 1.4% of the overall population. The net reclassification index across the Health ABC HF risk categories was 0.11 (95% CI 0.03-0.19).

CONCLUSIONS: Among older adults, baseline and new ECG abnormalities are independently associated with increased risk of HF. The contribution of ECG screening for targeted prevention of HF should be evaluated in clinical trials.


Publication types: Journal Article Publication Status: ppublish

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Alternate JournalAm. Heart J.
Citation Key / SERVAL ID3572
Peer reviewRefereed
PubMed ID24890537
PubMed Central IDPMC4081858
Grant ListN01 AG062101 / AG / NIA NIH HHS / United States
N01 AG062103 / AG / NIA NIH HHS / United States
N01 AG062106 / AG / NIA NIH HHS / United States
N01AG02101 / AG / NIA NIH HHS / United States
P30 AG024827 / AG / NIA NIH HHS / United States
R01 AG028050 / AG / NIA NIH HHS / United States


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