Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease

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dc.contributor.author Terho, Henri K.
dc.contributor.author Tikkanen, Jani T.
dc.contributor.author Kenttä, Tuomas V.
dc.contributor.author Junttila, Juhani M.
dc.contributor.author Aro, Aapo L.
dc.contributor.author Anttonen, Olli
dc.contributor.author Kerola, Tuomas
dc.contributor.author Rissanen, Harri A.
dc.contributor.author Knekt, Paul
dc.contributor.author Huikuri, Heikki V.
dc.date.accessioned 2018-08-29T09:06:01Z
dc.date.available 2018-08-29T09:06:01Z
dc.date.issued 2018-09
dc.identifier.citation Terho , H K , Tikkanen , J T , Kenttä , T V , Junttila , J M , Aro , A L , Anttonen , O , Kerola , T , Rissanen , H A , Knekt , P & Huikuri , H V 2018 , ' Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease ' , International journal of cardiology. Heart & vasculature , vol. 20 , pp. 50-55 . https://doi.org/10.1016/j.ijcha.2018.08.002
dc.identifier.other PURE: 115323797
dc.identifier.other PURE UUID: d67b52a6-0c07-49bb-a57a-734c7a4d4e99
dc.identifier.other RIS: urn:FADEC8B27468D2783C24D240FE0C7031
dc.identifier.other Scopus: 85052228724
dc.identifier.other ORCID: /0000-0001-7030-6740/work/48000110
dc.identifier.other WOS: 000444910200010
dc.identifier.uri http://hdl.handle.net/10138/240066
dc.description.abstract Background: Abnormal 12 lead electrocardiogram (ECG) findings and proposing its ability for enhanced risk prediction, majority of the studies have been carried out with elderly populations with prior cardiovascular diseases. This study aims to denote the association of sudden cardiac death (SCD) and various abnormal ECG morphologies using middle-aged population without a known cardiac disease. Methods: In total, 9511 middle-aged subjects (mean age 42 +/- 8.2 years, 52% males) without a known cardiac disease were included in this study. Risk for SCD was assessed after 10 and 30-years of follow-up. Results: Abnormal ECG was present in 16.3% (N = 1548) of subjects. The incidence of SCD was distinctly higher among those with any ECG abnormality in 10 and 30-year follow-ups (1.7/1000 years vs. 0.6/1000 years, P <0.001; 3.4;1000 years vs. 1.9/1000 years, P <0.001). At 10-year point, competing risk multivariate regression model showed HR of 1.62 (95% CI 1.0-2.6, P = 0.05) for SCD in subjects with abnormal ECG. QRS duration 110 ms, QRST-angle > 100', left ventricular hypertrophy, and T-wave inversions were the most significant independent ECG risk markers for 10-year SCD prediction with up to 3-fold risk for SCD. Those with ECG abnormalities had a 1.3-fold risk (95% CI 1.07-1.57, P - 0.007) for SCD in 30-year follow-up, whereas QRST-angle > 100 degrees, LVH, ER 0.1 mV and 0.2 mV were the strongest individual predictors. Subjects with multiple ECG abnormalities had up to 6.6-fold risk for SCD (P <0.001). Conclusion: Several ECG abnormalities are associated with the occurrence of early and late SCD events in the middle-age subjects without known history of cardiac disease. (C) 2018 The Authors. Published by Elsevier B.V. en
dc.format.extent 6
dc.language.iso eng
dc.relation.ispartof International journal of cardiology. Heart & vasculature
dc.rights cc_by_nc_nd
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Sudden cardiac death
dc.subject Risk prediction
dc.subject Electrocardiogram
dc.subject Follow-up studies
dc.subject QRS-T ANGLE
dc.subject LONG QT SYNDROME
dc.subject INTRAVENTRICULAR-CONDUCTION DELAY
dc.subject CORONARY-HEART-DISEASE
dc.subject MYOCARDIAL-INFARCTION
dc.subject EARLY REPOLARIZATION
dc.subject GENERAL-POPULATION
dc.subject UNEXPECTED DEATH
dc.subject RISK
dc.subject EPIDEMIOLOGY
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.title Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease en
dc.type Article
dc.contributor.organization Clinicum
dc.contributor.organization Department of Medicine
dc.contributor.organization Kardiologian yksikkö
dc.contributor.organization HYKS erva
dc.contributor.organization HUS Heart and Lung Center
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1016/j.ijcha.2018.08.002
dc.relation.issn 2352-9067
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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