{"id":28207,"date":"2012-04-10T19:06:11","date_gmt":"2012-04-10T23:06:11","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=28207"},"modified":"2012-04-10T19:06:11","modified_gmt":"2012-04-10T23:06:11","slug":"baseline-ecg-abnormalities-in-older-patients-tied-to-increased-chd-risk","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/04\/10\/baseline-ecg-abnormalities-in-older-patients-tied-to-increased-chd-risk\/","title":{"rendered":"Baseline ECG Abnormalities in Older Patients Tied to Increased CHD Risk"},"content":{"rendered":"<p>Although routine ECG screening in asymptomatic people is not recommended by guidelines, a new study raises the possibility that ECGs in an elderly population can provide a modest improvement in risk classification.<\/p>\n<p>In the Health, Aging, and Body Composition Study,<a href=\"http:\/\/jama.ama-assn.org\/content\/307\/14\/1497.full\"> published in\u00a0<em>JAMA<\/em><\/a>,\u00a0Reto Auer and colleagues followed 2192 adults 70 to 79 years of age without known cardiovascular disease.\u00a0People with any ECG abnormality at baseline had a significant increase in risk for CHD after adjustment for other risk factors:<\/p>\n<ul>\n<li>HR\u00a01.35, CI 1.02-1.8 (17.2 per 1000 person-years for those with no ECG abnormalities compared with 30.8 per 1000 person-years for those who had an ECG abnormality)<\/li>\n<\/ul>\n<p>The investigators report that by adding the ECG test to a model containing traditional risk factors, 7.1% of the overall population, and 13.6% of the intermediate-risk population, were reclassified. Eight percent of the intermediate-risk group were reclassified as high risk, and this group had an event rate of 15.2%. By contrast, 6.2% were reclassified as low risk, and this group had an event rate of 5.2%.<\/p>\n<p>The authors conclude that\u00a0because of &#8220;the safety, the low cost, and the wide availability of ECG, ECG data might be useful to improve CHD risk prediction in older adults.&#8221; But they stated that before the ECG becomes a routine screening test, it &#8220;should be evaluated in randomized controlled trials.&#8221;<\/p>\n<p>In<a href=\"http:\/\/jama.ama-assn.org\/content\/307\/14\/1530.short\"> an accompanying editorial<\/a>,\u00a0Philip Greenland points out that a sufficiently largely clinical trial would be prohibitively expensive and would have little likelihood of demonstrating substantial benefit. He advises that &#8220;in the absence of clear evidence of benefit and no clear implications for costs, the best advice is not to perform ECGs in asymptomatic patients, regardless of age.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Although routine ECG screening in asymptomatic people is not recommended by guidelines, a new study raises the possibility that ECGs in an elderly population can provide a modest improvement in risk classification. In the Health, Aging, and Body Composition Study, published in\u00a0JAMA,\u00a0Reto Auer and colleagues followed 2192 adults 70 to 79 years of age without [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,7],"tags":[1216,215,271],"class_list":["post-28207","post","type-post","status-publish","format-standard","hentry","category-general","category-prevention","tag-ecg","tag-risk-assessment","tag-risk-factors"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/28207","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=28207"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/28207\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=28207"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=28207"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=28207"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}