ECG readings would improve cardiovascular risk scores

ECG readings can provide better predictions of CHD risk than traditional risk factors and should be added to profiling tools, researchers believe.

ECG abnormalities double the CHD risk for elderly patients (Photograph: SPL)
ECG abnormalities double the CHD risk for elderly patients (Photograph: SPL)

AF, left ventricular hyper­trophy and other ECG abnor­malities double CHD risk among elderly patients, an int­ernational study has found.

Researchers led by Dr Reto Auer of the University of California argue that ECG should be added to traditional risk factors for assessing CHD risk in order to improve prediction of CHD events.

The researchers said CHD prediction was less accurate among elderly populations than middle-aged ones.

They believe ECG may be a valuable addition to risk profiling in this group, due to its low cost, wide use and safety.

Dr Auer and colleagues exam­ined medical records from 2,192 adults aged 70 to 79 years who did not have cardiovascular disease, looking for CHD events.

These patients underwent an ECG at baseline and after four years. The first scan found that 782 patients had either minor or major ECG abnormalities.

During the eight-year study period, 351 patients had CHD events. After adjusting for traditional risk factors, res­earchers found there were 29.3 CHD events per 1,000 patient-years among those with minor ECG abnormalities, and 31.6 events among those with major abnormalities.

This was far greater than in those patients without any detectable abnormalities, who experienced 17.2 events per 1,000 patient-years. After four years, those with new or persi­stent ECG abnormalities were twice as likely to experience a CHD event.

The researchers concluded: ‘We found that major and minor ECG abnormalities are associated with future CHD events and provide modestly improved risk reclassification beyond traditional risk factors. Whe­ther ECG should be incorporated in routine screening of older adults should be evaluated in RCTs.’

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