Including ECGs in routine cardiovascular risk assessments of older people would identify more patients at high risk of a coronary event, say US researchers.
The investigators studied over 2,000 participants aged 70 to 79 years without known cardiovascular disease. ECGs were recorded at baseline and at four years, with abnormalities categorised into major or minor.
They found both new and persistent ECG abnormalities were associated with a doubling of the risk of acute myocardial infarction, coronary death, hospitalisation for angina or coronary revascularisation.
ECG data also significantly improved the prediction of coronary heart disease beyond traditional cardiovascular risk factors. Using ECG data and that of traditional cardiovascular risk factors meant 8% of intermediate risk patients were reclassified as high risk, and 6.2% were reclassified as low risk. But when added to the Framingham score the overall improvement in the classification of risk was not significant.
Study lead Dr Reto Auer, research fellow at the University of California, said: ‘Given the low safety, the low cost, and the wide availability of ECG, ECG data might be useful to improve CHD risk prediction in older adults.’
JAMA 2012; 307: 1497-1505