Open AccessIndependent Prognostic Value of Single and Multiple Non-Specific 12-Lead Electrocardiographic Findings for Long-Term Cardiovascular Outcomes: A Prospective Cohort Study
Author(s) -
Mitsuaki Sawano,
Shun Kohsaka,
Tomonori Okamura,
Taku Inohara,
Daisuke Sugiyama,
Yasuyuki Shiraishi,
Makoto Watanabe,
Yasuyuki Nakamura,
Aya Higashiyama,
Aya Kadota,
Nagako Okuda,
Yoshitaka Murakami,
Takayoshi Ohkubo,
Akira Fujiyoshi,
Katsuyuki Miura,
Akira Okayama,
Hirotsugu Ueshima,
Nippon Data
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0157563
Subject(s) - prospective cohort study , medicine , term (time) , lead (geology) , cohort study , cardiology , cohort , proportional hazards model , biology , paleontology , physics , quantum mechanics
Aims The long-term prognostic effect of non-specific 12-lead electrocardiogram findings is unknown. We aimed to evaluate the cumulative prognostic impact of axial, structural, and repolarization categorical abnormalities on cardiovascular death, independent from traditional risk scoring systems such as the Framingham risk score and the NIPPON DATA80 risk chart. Methods and Results A total of 16,816 healthy men and women from two prospective, longitudinal cohort studies were evaluated. 3,794 (22.6%) individuals died during a median follow-up of 15 years (range, 2.0–24 years). Hazard ratios for cardiovascular death, all-cause death, coronary death and stroke death were calculated for the cumulative and independent axial, structural, and repolarization categorical abnormalities adjusted for the Framingham risk score and the NIPPON DATA80 risk chart. Individuals with two or more abnormal categories had a higher risk of cardiovascular death after adjustment for Framingham risk score (men: HR 4.27, 95%CI 3.35–5.45; women: HR 4.83, 95%CI 3.76–6.22) and NIPPON DATA80 risk chart (men: HR 2.39, 95%CI 1.87–3.07; women: HR 2.04, 95%CI 1.58–2.64). Conclusion Cumulative findings of axial, structural, and repolarization abnormalities are significant predictors of long-term cardiovascular death in asymptomatic, healthy individuals independent of traditional risk stratification systems.