Document Detail


Usefulness of the Electrocardiogram in Predicting Cardiovascular Mortality in Asymptomatic Adults With Aortic Stenosis (from the Simvastatin and Ezetimibe in Aortic Stenosis Study).
MedLine Citation:
PMID:  25048345     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Hypertension and coronary heart disease are common in aortic stenosis (AS) and may impair prognosis for similar AS severity. Different changes in the electrocardiogram may be reflective of the separate impacts of AS, hypertension, and coronary heart disease, which could lead to enhanced risk stratification in AS. The aim of this study was therefore to examine if combining prognostically relevant electrocardiographic (ECG) findings improves prediction of cardiovascular mortality in asymptomatic AS. All patients with baseline electrocardiograms in the SEAS study were included. The primary end point was cardiovascular death. Backward elimination (p >0.01) identified heart rate, Q waves, and Cornell voltage-duration product as independently associated with cardiovascular death. Multivariate logistic and Cox regression models were used to evaluate if these 3 ECG variables improved prediction of cardiovascular death. In 1,473 patients followed for a mean of 4.3 years (6,362 patient-years of follow-up), 70 cardiovascular deaths (5%) occurred. In multivariate analysis, heart rate (hazard ratio [HR] 1.5 per 11.2 minute(-1) [1 SD], 95% confidence interval [CI] 1.2 to 1.8), sum of Q-wave amplitude (HR 1.3 per 2.0 mm [1 SD], 95% CI 1.1 to 1.6), and Cornell voltage-duration product (HR 1.4 per 763 mm × ms [1 SD], 95% CI 1.2 to 1.7) remained independently associated with cardiovascular death. Combining the prognostic information contained in each of the 3 ECG variables improved integrated discrimination for prediction of cardiovascular death by 2.5%, net reclassification by 14.3%, and area under the curve by 0.06 (all p ≤0.04) beyond other important risk factors. ECG findings add incremental predictive information for cardiovascular mortality in asymptomatic patients with AS.
Authors:
Anders M Greve; Morten Dalsgaard; Casper N Bang; Kenneth Egstrup; Anne B Rossebø; Kurt Boman; Dana Cramariuc; Christoph A Nienaber; Simon Ray; Christa Gohlke-Baerwolf; Peter M Okin; Richard B Devereux; Lars Køber; Kristian Wachtell
Related Documents :
16234615 - Elevated troponin levels associated with hemolysis.
21159165 - The effect of tobacco smoking and treatment strategy on the one-year mortality of patie...
21398655 - The significance of the shape of the left atrial roof as a novel index for determining ...
21511435 - Apical hypertrophic cardiomyopathy: prevalence and correlates of apical outpouching.
1529795 - Role of peptido-leukotrienes in the genesis of early ventricular arrhythmias during acu...
19415735 - Splenic infarction and subsequent splenic rupture in a patient with paroxysmal nocturna...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-21
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-7-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Comparison by Optical Coherence Tomography of the Frequency of Lipid Coronary Plaques in Current Smo...
Next Document:  Current State of mTOR Targeting in Human Breast Cancer.