Krittayaphong Rungroj, Muenkaew Muenpetch, Chiewvit Polakit, Ratanasit Nithima, Kaolawanich Yodying, Phrommintikul Arintaya
Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of Cardiology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
J Geriatr Cardiol. 2019 Aug;16(8):630-638. doi: 10.11909/j.issn.1671-5411.2019.08.004.
There are limited data on the prevalence of electrocardiographic (ECG) abnormalities, and their value for predicting a major adverse cardiovascular event (MACE) in patients at high cardiovascular risk. This study aimed to determine the prevalence of ECG abnormalities in patients at high risk for cardiovascular events, and to identify ECG abnormalities that significantly predict MACE.
Patients aged ≥ 45 years with established atherosclerotic disease (EAD) were consecutively enrolled from the outpatient clinics of the six participating hospitals during April 2011 to March 2014. The following data were collected: demographic data, cardiovascular risk factors, history of cardiovascular event, physical examination, ECG and medications. ECG was analyzed using Minnesota Code criteria. MACE included cardiovascular death, non-fatal myocardial infarction, and hospitalization due to unstable angina or heart failure.
A total of 2009 patients were included, 1048 patients (52.2%) had established EAD, and 961 patients (47.8%) had multiple risk factors (MRF). ECG abnormalities included atrial fibrillation (6.7%), premature ventricular contraction (5.4%), pathological Q-wave (Q/QS) (21.3%), T-wave inversion (20.0%), intraventricular ventricular conduction delay (IVCD) (7.3%), left ventricular hypertrophy (LVH) (12.2%), and AV block (12.5%). MACE occurred in 88 patients (4.4%). Independent predictors of MACE were chronic kidney disease, EAD, and the presence of atrial fibrillation, Q/QS, IVCD or LVH by ECG.
A high prevalence of ECG abnormalities was found. The prevalence of ECG abnormalities was high even among those with risk factors without documented cardiovascular disease.
关于心电图（ECG）异常的患病率及其在心血管高危患者中预测主要不良心血管事件（MACE）的价值的数据有限。本研究旨在确定心血管事件高危患者中ECG异常的患病率，并识别能显著预测MACE的ECG异常。
2011年4月至2014年3月期间，从六家参与研究的医院门诊连续纳入年龄≥45岁且患有确诊动脉粥样硬化疾病（EAD）的患者。收集以下数据：人口统计学数据、心血管危险因素、心血管事件史、体格检查、ECG和用药情况。使用明尼苏达编码标准分析ECG。MACE包括心血管死亡、非致命性心肌梗死以及因不稳定型心绞痛或心力衰竭住院。
共纳入2009例患者，1048例患者（52.2%）患有确诊EAD，961例患者（47.8%）有多种危险因素（MRF）。ECG异常包括心房颤动（6.7%）、室性早搏（5.4%）、病理性Q波（Q/QS）（21.3%）、T波倒置（20.0%）、室内传导延迟（IVCD）（7.3%）、左心室肥厚（LVH）（12.2%）和房室传导阻滞（12.5%）。88例患者（4.4%）发生了MACE。MACE的独立预测因素为慢性肾脏病、EAD以及ECG显示存在心房颤动、Q/QS、IVCD或LVH。
发现ECG异常的患病率较高。即使在那些有危险因素但无心血管疾病记录的患者中，ECG异常的患病率也很高。
