ECG abnormalities a red flag for mortality in low-risk population

Among relatively healthy individuals, major electrocardiogram (ECG) abnormalities such as left atrial enlargement (LAE) and left ventricular hypertrophy (LVH), among others, predict increased mortality, as shown in a retrospective study.

The study involved 660,383 individuals presenting for medical checkups. Researchers analysed the participants’ baseline ECG data in relation to the risk of all-cause and cardiovascular mortality. Baseline ECG abnormalities were classified according to the Minnesota Code.

Of the participants, 23,609 (3.6 percent) had major ECG abnormalities while 110,038 (16.7 percent) had minor ECG abnormalities. Over a median follow‐up of 8.8 years, all‐cause and cardiovascular mortality was documented in 7,751 (1.1 percent) and in 1,180 (0.18 percent) patients, respectively.

Multivariable Cox proportional hazard models showed that compared with the absence of abnormalities, major ECG abnormalities were associated with increased risk of all‐cause mortality (hazard ratio [HR], 1.11, 95 percent confidence interval [CI], 1.03–1.2) and cardiovascular mortality (HR, 1.92, 95 percent CI, 1.63–2.27).

Predictors of all‐cause mortality included right atrial enlargement (HR, 2.11, 95 percent CI, 1.1–4.07), left atrial enlargement (HR, 1.76, 95 percent CI, 1.1–2.84), sinus tachycardia (HR, 1.52, 95 percent CI, 1.15–2.01), complete atrioventricular block (HR, 2.1, 95 percent CI, 1.05–4.2), atrial fibrillation (HR, 1.52, 95 percent CI, 1.26–1.84), and left ventricular hypertrophy (HR, 1.15, 95 percent CI, 1.02–1.3).

For cardiovascular mortality, predictors included left atrial enlargement (HR, 4.52, 95 percent CI, 2.15–9.5), atrial fibrillation (HR, 3.22, 95 percent CI, 2.33–4.46), left ventricular hypertrophy (HR, 1.72, 95 percent CI, 1.35–2.19), major Q‐wave abnormality (HR, 1.6, 95 percent CI, 1.08–2.39), and major ST‐T abnormality (HR, 1.76, 95 percent CI, 1.01–3.04).

The findings indicate that ECG could allow early diagnosis of cardiovascular problems that could impact mortality in a low‐risk population, the researchers said.