ECGs no better than routine clinical assessment at predicting heart disease

Electrocardiogram (ECGs) are of little additional benefit on top of basic clinical assessments for angina, a BMJ study shows.

Credit: iStockphoto/Emrah Turudu
Credit: iStockphoto/Emrah Turudu

Given that ECGs are routine in most UK chest pain clinics, the finding shows that better risk stratification is needed for angina patients, the researchers say.

Basic clinical assessments and resting ECGs were collected for 8,176 patients with suspected angina, of whom 4,848 also had summary exercise ECGs recorded and 1,422 had detailed exercise ECGs recorded.

The researchers found that the basic clinical assessment encompassed almost all of the prognostic value of the resting ECGs and most of the prognostic value of exercise ECGs.

‘The limited incremental value of these widely applied non-invasive investigations extended across all [levels] of risk, emphasising the importance of the clinical assessment and the need for more effective methods of risk stratification in this group of patients,’ the researchers say.

BMJ Online First 2008

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