Independent prognostic value of single and multiple non-specific 12-lead electrocardiographic findings for long-term cardiovascular outcomes: A prospective cohort study

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

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Abstract

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.

Original languageEnglish
Article numbere0157563
JournalPloS one
Volume11
Issue number6
DOIs
Publication statusPublished - 2016 Jun

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    Sawano, M., Kohsaka, S., Okamura, T., Inohara, T., Sugiyama, D., Shiraishi, Y., Watanabe, M., Nakamura, Y., Higashiyama, A., Kadota, A., Okuda, N., Murakami, Y., Ohkubo, T., Fujiyoshi, A., Miura, K., Okayama, A., & Ueshima, H. (2016). Independent prognostic value of single and multiple non-specific 12-lead electrocardiographic findings for long-term cardiovascular outcomes: A prospective cohort study. PloS one, 11(6), [e0157563]. https://doi.org/10.1371/journal.pone.0157563