Subclinical coronary atherosclerosis and resting ECG abnormalities in an unselected general population
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Subclinical coronary atherosclerosis and resting ECG abnormalities in an unselected general population. / Möhlenkamp, Stefan; Schmermund, Axel; Lehmann, Nils; Roggenbuck, Ulla; Dragano, Nico; Stang, Andreas; Moebus, Susanne; Beck, Eva-Maria; Schlüter, Christamaria; Sack, Stefan; Meinertz, Thomas; Taylor, Allen; Jöckel, Karl-Heinz; Erbel, Raimund; Heinz Nixdorf Recall Study Investigators.
in: ATHEROSCLEROSIS, Jahrgang 196, Nr. 2, 02.2008, S. 786-794.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Subclinical coronary atherosclerosis and resting ECG abnormalities in an unselected general population
AU - Möhlenkamp, Stefan
AU - Schmermund, Axel
AU - Lehmann, Nils
AU - Roggenbuck, Ulla
AU - Dragano, Nico
AU - Stang, Andreas
AU - Moebus, Susanne
AU - Beck, Eva-Maria
AU - Schlüter, Christamaria
AU - Sack, Stefan
AU - Meinertz, Thomas
AU - Taylor, Allen
AU - Jöckel, Karl-Heinz
AU - Erbel, Raimund
AU - Heinz Nixdorf Recall Study Investigators
PY - 2008/2
Y1 - 2008/2
N2 - OBJECTIVES: Exposure to cardiovascular (CV) risk factors may result in coronary atherosclerosis and myocardial disease, which is reflected in the extent of coronary artery calcification (CAC) and resting ECG abnormalities, respectively. We studied the association of CAC with ECG abnormalities in a general population without myocardial infarction or revascularization.METHODS: The total cohort of 4814 subjects (45-75 years) were randomly selected from the general population for the Heinz Nixdorf Recall Study, an ongoing study designed to assess the prognostic value of modern risk stratification methods. In addition to measuring standard risk factors, digitized resting ECGs and the EBT-based Agatston score were obtained. Subjects were separated into those without (n=1929) and with CV disease (CVD) or treated risk factors (tRF) (n=2558).RESULTS: In both groups, a positive CAC-score was more frequent and CAC-scores were higher in men and women with ECG abnormalities as compared to those with normal ECGs (p<0.05 each). In persons without CVD/tRF, a CAC > or =75th percentile was more frequent in those with LVH (42.4%) and QTc >440 ms (34.2%) as compared to normal ECGs (23.0%, p<0.01 for both). In persons with CVD/tRF, a CAC-score > or =75th percentile was found in subjects with A-Fib (46.3%), borderline-LVH (39.1%), ECG signs of MI (40.5%) and major ECG abnormalities (40.3%) versus 31.2% in those with normal ECGs (p<0.03 for all). In multivariate analysis, LVH (p=0.025) and major ECG abnormalities (p=0.04) remained independently associated with CAC in subjects without and with CVD/tRF, respectively.CONCLUSIONS: ECG-based evidence of myocardial disease is often associated with an elevated CAC burden, suggesting a link between epicardial and myocardial manifestations of risk factor exposure. The association of CAC burden with different ECG abnormalities in different clinical groups may have implications for the interpretation of the resting ECG and CAC burden in risk stratification.
AB - OBJECTIVES: Exposure to cardiovascular (CV) risk factors may result in coronary atherosclerosis and myocardial disease, which is reflected in the extent of coronary artery calcification (CAC) and resting ECG abnormalities, respectively. We studied the association of CAC with ECG abnormalities in a general population without myocardial infarction or revascularization.METHODS: The total cohort of 4814 subjects (45-75 years) were randomly selected from the general population for the Heinz Nixdorf Recall Study, an ongoing study designed to assess the prognostic value of modern risk stratification methods. In addition to measuring standard risk factors, digitized resting ECGs and the EBT-based Agatston score were obtained. Subjects were separated into those without (n=1929) and with CV disease (CVD) or treated risk factors (tRF) (n=2558).RESULTS: In both groups, a positive CAC-score was more frequent and CAC-scores were higher in men and women with ECG abnormalities as compared to those with normal ECGs (p<0.05 each). In persons without CVD/tRF, a CAC > or =75th percentile was more frequent in those with LVH (42.4%) and QTc >440 ms (34.2%) as compared to normal ECGs (23.0%, p<0.01 for both). In persons with CVD/tRF, a CAC-score > or =75th percentile was found in subjects with A-Fib (46.3%), borderline-LVH (39.1%), ECG signs of MI (40.5%) and major ECG abnormalities (40.3%) versus 31.2% in those with normal ECGs (p<0.03 for all). In multivariate analysis, LVH (p=0.025) and major ECG abnormalities (p=0.04) remained independently associated with CAC in subjects without and with CVD/tRF, respectively.CONCLUSIONS: ECG-based evidence of myocardial disease is often associated with an elevated CAC burden, suggesting a link between epicardial and myocardial manifestations of risk factor exposure. The association of CAC burden with different ECG abnormalities in different clinical groups may have implications for the interpretation of the resting ECG and CAC burden in risk stratification.
KW - Aged
KW - Calcinosis/diagnosis
KW - Cohort Studies
KW - Coronary Artery Disease/diagnosis
KW - Electrocardiography
KW - Female
KW - Germany
KW - Humans
KW - Hypertrophy, Left Ventricular/etiology
KW - Male
KW - Middle Aged
KW - Predictive Value of Tests
KW - Risk Factors
KW - Sensitivity and Specificity
U2 - 10.1016/j.atherosclerosis.2007.01.012
DO - 10.1016/j.atherosclerosis.2007.01.012
M3 - SCORING: Journal article
C2 - 17350632
VL - 196
SP - 786
EP - 794
JO - ATHEROSCLEROSIS
JF - ATHEROSCLEROSIS
SN - 0021-9150
IS - 2
ER -