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. 2016 Jun 30;11(6):e0157563.
doi: 10.1371/journal.pone.0157563. eCollection 2016.

Independent Prognostic Value of Single and Multiple Non-Specific 12-Lead Electrocardiographic Findings for Long-Term Cardiovascular Outcomes: A Prospective Cohort Study

Mitsuaki Sawano  1 , Shun Kohsaka  1 , Tomonori Okamura  2 , Taku Inohara  1 , Daisuke Sugiyama  2 , Yasuyuki Shiraishi  1 , Makoto Watanabe  3 , Yasuyuki Nakamura  4 , Aya Higashiyama  5 , Aya Kadota  6 , Nagako Okuda  7 , Yoshitaka Murakami  8 , Takayoshi Ohkubo  9 , Akira Fujiyoshi  6   10 , Katsuyuki Miura  6   10 , Akira Okayama  11 , Hirotsugu Ueshima  6   10 ; NIPPON DATA 80/90 Research Group
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Independent Prognostic Value of Single and Multiple Non-Specific 12-Lead Electrocardiographic Findings for Long-Term Cardiovascular Outcomes: A Prospective Cohort Study

Mitsuaki Sawano et al. PLoS One. .

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Frequency of Axial, Structural and Repolarization Abnormalities Divided by Gender.
Fig 1A. Men. Fig 1B. Women.
Fig 2
Fig 2. Hazard Ratios Adjusted for Framingham Risk Score and Risk Probability with NIPPON DATA80 Risk Chart.
See this image and copyright information in PMC

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