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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Association of electrocardiogram abnormalities and incident heart failure events</title>
<author><name sortKey="Gencer, Baris" sort="Gencer, Baris" uniqKey="Gencer B" first="Baris" last="Gencer">Baris Gencer</name>
<affiliation><nlm:aff id="A1">Cardiology Division, Department of Medicine, Geneva University Hospital, Geneva, Switzerland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Butler, Javed" sort="Butler, Javed" uniqKey="Butler J" first="Javed" last="Butler">Javed Butler</name>
<affiliation><nlm:aff id="A2">Cardiology Division, Emory University, Atlanta, GA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bauer, Douglas C" sort="Bauer, Douglas C" uniqKey="Bauer D" first="Douglas C." last="Bauer">Douglas C. Bauer</name>
<affiliation><nlm:aff id="A3">Department of Medicine, University of California, San Francisco, CA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Department of Epidemiology and Biostatistics, University of California, San Francisco, CA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Auer, Reto" sort="Auer, Reto" uniqKey="Auer R" first="Reto" last="Auer">Reto Auer</name>
<affiliation><nlm:aff id="A4">Department of Epidemiology and Biostatistics, University of California, San Francisco, CA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kalogeropoulos, Andreas" sort="Kalogeropoulos, Andreas" uniqKey="Kalogeropoulos A" first="Andreas" last="Kalogeropoulos">Andreas Kalogeropoulos</name>
<affiliation><nlm:aff id="A2">Cardiology Division, Emory University, Atlanta, GA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Marques Vidal, Pedro" sort="Marques Vidal, Pedro" uniqKey="Marques Vidal P" first="Pedro" last="Marques-Vidal">Pedro Marques-Vidal</name>
<affiliation><nlm:aff id="A5">Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A6">Clinical Research Centre, Lausanne University Hospital, Lausanne, Switzerland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Applegate, William B" sort="Applegate, William B" uniqKey="Applegate W" first="William B." last="Applegate">William B. Applegate</name>
<affiliation><nlm:aff id="A7">Internal Medicine and Geriatric Medicine, Wake Forest University Baptist Medical Center, Winston Salem, NC</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Satterfield, Suzanne" sort="Satterfield, Suzanne" uniqKey="Satterfield S" first="Suzanne" last="Satterfield">Suzanne Satterfield</name>
<affiliation><nlm:aff id="A8">Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Harris, Tamara" sort="Harris, Tamara" uniqKey="Harris T" first="Tamara" last="Harris">Tamara Harris</name>
<affiliation><nlm:aff id="A9">Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Newman, Anne" sort="Newman, Anne" uniqKey="Newman A" first="Anne" last="Newman">Anne Newman</name>
<affiliation><nlm:aff id="A10">Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Vittinghoff, Eric" sort="Vittinghoff, Eric" uniqKey="Vittinghoff E" first="Eric" last="Vittinghoff">Eric Vittinghoff</name>
<affiliation><nlm:aff id="A4">Department of Epidemiology and Biostatistics, University of California, San Francisco, CA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rodondi, Nicolas" sort="Rodondi, Nicolas" uniqKey="Rodondi N" first="Nicolas" last="Rodondi">Nicolas Rodondi</name>
<affiliation><nlm:aff id="A11">Department of General Internal Medicine, University of Bern, Bern, Switzerland</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">24890537</idno>
<idno type="pmc">4081858</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4081858</idno>
<idno type="RBID">PMC:4081858</idno>
<idno type="doi">10.1016/j.ahj.2014.03.020</idno>
<date when="2014">2014</date>
<idno type="wicri:Area/Pmc/Corpus">000E19</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000E19</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Association of electrocardiogram abnormalities and incident heart failure events</title>
<author><name sortKey="Gencer, Baris" sort="Gencer, Baris" uniqKey="Gencer B" first="Baris" last="Gencer">Baris Gencer</name>
<affiliation><nlm:aff id="A1">Cardiology Division, Department of Medicine, Geneva University Hospital, Geneva, Switzerland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Butler, Javed" sort="Butler, Javed" uniqKey="Butler J" first="Javed" last="Butler">Javed Butler</name>
<affiliation><nlm:aff id="A2">Cardiology Division, Emory University, Atlanta, GA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bauer, Douglas C" sort="Bauer, Douglas C" uniqKey="Bauer D" first="Douglas C." last="Bauer">Douglas C. Bauer</name>
<affiliation><nlm:aff id="A3">Department of Medicine, University of California, San Francisco, CA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Department of Epidemiology and Biostatistics, University of California, San Francisco, CA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Auer, Reto" sort="Auer, Reto" uniqKey="Auer R" first="Reto" last="Auer">Reto Auer</name>
<affiliation><nlm:aff id="A4">Department of Epidemiology and Biostatistics, University of California, San Francisco, CA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kalogeropoulos, Andreas" sort="Kalogeropoulos, Andreas" uniqKey="Kalogeropoulos A" first="Andreas" last="Kalogeropoulos">Andreas Kalogeropoulos</name>
<affiliation><nlm:aff id="A2">Cardiology Division, Emory University, Atlanta, GA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Marques Vidal, Pedro" sort="Marques Vidal, Pedro" uniqKey="Marques Vidal P" first="Pedro" last="Marques-Vidal">Pedro Marques-Vidal</name>
<affiliation><nlm:aff id="A5">Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A6">Clinical Research Centre, Lausanne University Hospital, Lausanne, Switzerland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Applegate, William B" sort="Applegate, William B" uniqKey="Applegate W" first="William B." last="Applegate">William B. Applegate</name>
<affiliation><nlm:aff id="A7">Internal Medicine and Geriatric Medicine, Wake Forest University Baptist Medical Center, Winston Salem, NC</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Satterfield, Suzanne" sort="Satterfield, Suzanne" uniqKey="Satterfield S" first="Suzanne" last="Satterfield">Suzanne Satterfield</name>
<affiliation><nlm:aff id="A8">Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Harris, Tamara" sort="Harris, Tamara" uniqKey="Harris T" first="Tamara" last="Harris">Tamara Harris</name>
<affiliation><nlm:aff id="A9">Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Newman, Anne" sort="Newman, Anne" uniqKey="Newman A" first="Anne" last="Newman">Anne Newman</name>
<affiliation><nlm:aff id="A10">Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Vittinghoff, Eric" sort="Vittinghoff, Eric" uniqKey="Vittinghoff E" first="Eric" last="Vittinghoff">Eric Vittinghoff</name>
<affiliation><nlm:aff id="A4">Department of Epidemiology and Biostatistics, University of California, San Francisco, CA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rodondi, Nicolas" sort="Rodondi, Nicolas" uniqKey="Rodondi N" first="Nicolas" last="Rodondi">Nicolas Rodondi</name>
<affiliation><nlm:aff id="A11">Department of General Internal Medicine, University of Bern, Bern, Switzerland</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">American heart journal</title>
<idno type="ISSN">0002-8703</idno>
<idno type="eISSN">1097-6744</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Unless effective preventive strategies are implemented, aging of the population will result in a significant worsening of the heart failure (HF) epidemic. Few data exist on whether baseline electrocardiographic (ECG) abnormalities can refine risk prediction for HF.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We examined a prospective cohort of 2,915 participants aged 70 to 79 years without preexisting HF, enrolled between April 1997 and June 1998 in the Health, Aging, and Body Composition (Health ABC) study. Minnesota Code was used to define major and minor ECG abnormalities at baseline and at year 4 follow-up. Using Cox models, we assessed (1) the association between ECG abnormalities and incident HF and (2) the incremental value of adding ECG to the Health ABC HF Risk Score using the net reclassification index.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">At baseline, 380 participants (13.0%) had minor, and 620 (21.3%) had major ECG abnormalities. During a median follow-up of 11.4 years, 485 participants (16.6%) developed incident HF. After adjusting for the Health ABC HF Risk Score variables, the hazard ratio (HR) was 1.27 (95% CI 0.96–1.68) for minor and 1.99 (95% CI 1.61–2.44) for major ECG abnormalities. At year 4, 263 participants developed new and 549 had persistent abnormalities; both were associated with increased subsequent HF risk (HR 1.94, 95% CI 1.38–2.72 for new and HR 2.35, 95% CI 1.82–3.02 for persistent ECG abnormalities). Baseline ECG correctly reclassified 10.5% of patients with HF events, 0.8% of those without HF events, and 1.4% of the overall population. The net reclassification index across the Health ABC HF risk categories was 0.11 (95% CI 0.03–0.19).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Among older adults, baseline and new ECG abnormalities are independently associated with increased risk of HF. The contribution of ECG screening for targeted prevention of HF should be evaluated in clinical trials.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0370465</journal-id>
<journal-id journal-id-type="pubmed-jr-id">398</journal-id>
<journal-id journal-id-type="nlm-ta">Am Heart J</journal-id>
<journal-id journal-id-type="iso-abbrev">Am. Heart J.</journal-id>
<journal-title-group><journal-title>American heart journal</journal-title>
</journal-title-group>
<issn pub-type="ppub">0002-8703</issn>
<issn pub-type="epub">1097-6744</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24890537</article-id>
<article-id pub-id-type="pmc">4081858</article-id>
<article-id pub-id-type="doi">10.1016/j.ahj.2014.03.020</article-id>
<article-id pub-id-type="manuscript">NIHMS584407</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Association of electrocardiogram abnormalities and incident heart failure events</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Gencer</surname>
<given-names>Baris</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">a</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Butler</surname>
<given-names>Javed</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="A2">b</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bauer</surname>
<given-names>Douglas C.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A3">c</xref>
<xref ref-type="aff" rid="A4">d</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Auer</surname>
<given-names>Reto</given-names>
</name>
<degrees>MD, MAS</degrees>
<xref ref-type="aff" rid="A4">d</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kalogeropoulos</surname>
<given-names>Andreas</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A2">b</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Marques-Vidal</surname>
<given-names>Pedro</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A5">e</xref>
<xref ref-type="aff" rid="A6">f</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Applegate</surname>
<given-names>William B.</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="A7">g</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Satterfield</surname>
<given-names>Suzanne</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A8">h</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Harris</surname>
<given-names>Tamara</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A9">i</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Newman</surname>
<given-names>Anne</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="A10">j</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Vittinghoff</surname>
<given-names>Eric</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A4">d</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rodondi</surname>
<given-names>Nicolas</given-names>
</name>
<degrees>MD, MAS</degrees>
<email>Nicolas.Rodondi@insel.ch</email>
<xref ref-type="aff" rid="A11">k</xref>
</contrib>
<contrib contrib-type="author"><collab>for the Health ABC Study</collab>
</contrib>
</contrib-group>
<aff id="A1"><label>a</label>
Cardiology Division, Department of Medicine, Geneva University Hospital, Geneva, Switzerland</aff>
<aff id="A2"><label>b</label>
Cardiology Division, Emory University, Atlanta, GA</aff>
<aff id="A3"><label>c</label>
Department of Medicine, University of California, San Francisco, CA</aff>
<aff id="A4"><label>d</label>
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA</aff>
<aff id="A5"><label>e</label>
Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland</aff>
<aff id="A6"><label>f</label>
Clinical Research Centre, Lausanne University Hospital, Lausanne, Switzerland</aff>
<aff id="A7"><label>g</label>
Internal Medicine and Geriatric Medicine, Wake Forest University Baptist Medical Center, Winston Salem, NC</aff>
<aff id="A8"><label>h</label>
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN</aff>
<aff id="A9"><label>i</label>
Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD</aff>
<aff id="A10"><label>j</label>
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA</aff>
<aff id="A11"><label>k</label>
Department of General Internal Medicine, University of Bern, Bern, Switzerland</aff>
<pub-date pub-type="nihms-submitted"><day>31</day>
<month>5</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>05</day>
<month>4</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><month>6</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>6</month>
<year>2015</year>
</pub-date>
<volume>167</volume>
<issue>6</issue>
<fpage>869</fpage>
<lpage>875.e3</lpage>
<pmc-comment>elocation-id from pubmed: 10.1016/j.ahj.2014.03.020</pmc-comment>
<permissions><copyright-statement>© 2014, Mosby, Inc. All rights reserved.</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Unless effective preventive strategies are implemented, aging of the population will result in a significant worsening of the heart failure (HF) epidemic. Few data exist on whether baseline electrocardiographic (ECG) abnormalities can refine risk prediction for HF.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We examined a prospective cohort of 2,915 participants aged 70 to 79 years without preexisting HF, enrolled between April 1997 and June 1998 in the Health, Aging, and Body Composition (Health ABC) study. Minnesota Code was used to define major and minor ECG abnormalities at baseline and at year 4 follow-up. Using Cox models, we assessed (1) the association between ECG abnormalities and incident HF and (2) the incremental value of adding ECG to the Health ABC HF Risk Score using the net reclassification index.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">At baseline, 380 participants (13.0%) had minor, and 620 (21.3%) had major ECG abnormalities. During a median follow-up of 11.4 years, 485 participants (16.6%) developed incident HF. After adjusting for the Health ABC HF Risk Score variables, the hazard ratio (HR) was 1.27 (95% CI 0.96–1.68) for minor and 1.99 (95% CI 1.61–2.44) for major ECG abnormalities. At year 4, 263 participants developed new and 549 had persistent abnormalities; both were associated with increased subsequent HF risk (HR 1.94, 95% CI 1.38–2.72 for new and HR 2.35, 95% CI 1.82–3.02 for persistent ECG abnormalities). Baseline ECG correctly reclassified 10.5% of patients with HF events, 0.8% of those without HF events, and 1.4% of the overall population. The net reclassification index across the Health ABC HF risk categories was 0.11 (95% CI 0.03–0.19).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Among older adults, baseline and new ECG abnormalities are independently associated with increased risk of HF. The contribution of ECG screening for targeted prevention of HF should be evaluated in clinical trials.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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