Introduction:
Cardiovascular diseases (CVD) are the most preventable noncommunicable diseases. Accurate risk stratification is paramount for identifying patients for whom interventions should be offered. The electrocardiogram (ECG) is a potential tool for CVD primary prevention. Our aim is to evaluate the ECG role as an independent predictor of all-cause and cardiovascular mortality
Methods:
Participants from the Longitudinal Study of Adult Health (ELSA-Brasil), who were 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 and hospitalizations were independently reviewed. Cox and Fine and Gray competitive risk regressions were applied to evaluate if the presence of any major electrocardiographic abnormality (MEA) at baseline, defined according to de Minnesota Code system (MC), would predict total and cardiovascular deaths in multivariable models
Results:
The 13,437 participants (mean age 51.8 years, 55% women) were followed for 8±1 years. Baseline prevalence of MEA was 7.2% for men, 5.8% for women. All-cause and cardiovascular mortality occurred in 5.7% and 1.2% of men, and 3.1% and 1.2% of women, respectively. Prevalent MEA was an independent predictor of overall mortality after adjustments for age, race, education and traditional cardiovascular risk factors (HR:2.2; 95%CI 1.6-2.9 for men and HR:2.3; 95%CI 1.6-3.4 for women). [LB1] In the competitive risk model for cardiovascular death, the increased risk attributable to MEA was even higher (HR4.1, 95%CI 2.47-6.81 in men and 5.37, 95%CI 2.54-11.36 in women).
Conclusions:
Presence of MEA was a strong and independent predictor of overall and cardiovascular death for both sexes. ECG may have a role in improving risk assessment for death in primary care
An unusual electrocardiographic abnormality