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Associations between common ECG abnormalities and out-of-hospital cardiac arrest

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@article{7f6d6887c2b34ccb8207f148065f5ec7,
title = "Associations between common ECG abnormalities and out-of-hospital cardiac arrest",
abstract = "Background: Out-of-hospital cardiac arrest (OHCA) is often the first manifestation of unrecognised cardiac disease. ECG abnormalities encountered in primary care settings may be warning signs of OHCA.Objective: We examined the association between common ECG abnormalities and OHCA in a primary care setting.Methods: We cross-linked individuals who had an ECG recording between 2001 and 2011 in a primary care setting with the Danish Cardiac Arrest Registry and identified OHCAs of presumed cardiac cause.Results: A total of 326 227 individuals were included and 2667 (0,8{\%}) suffered an OHCA. In Cox regression analyses, adjusted for age and sex, the following ECG findings were strongly associated with OHCA: ST-depression without concomitant atrial fibrillation (HR 2.79; 95{\%} CI 2.45 to 3.18), left bundle branch block (LBBB; HR 3.44; 95{\%} CI 2.85 to 4.14) and non-specific intraventricular block (NSIB; HR 3.15; 95{\%} CI 2.58 to 3.83). Also associated with OHCA were atrial fibrillation (HR 1.89; 95{\%} CI 1.63 to 2.18), Q-wave (HR 1.75; 95{\%} CI 1.57 to 1.95), Cornell and Sokolow-Lyon criteria for left ventricular hypertrophy (HR 1.56; 95{\%} CI 1.33 to 1.82 and HR 1.27; 95{\%} CI 1.12 to 1.45, respectively), ST-elevation (HR 1.40; 95{\%} CI 1.09 to 1.54) and right bundle branch block (HR 1.29; 95{\%} CI 1.09 to 1.54). The association between ST-depression and OHCA diminished with concomitant atrial fibrillation (HR 1.79; 95{\%} CI 1.42 to 2.24, p < 0.01 for interaction). Among patients suffering from OHCA, without a known cardiac disease at the time of the cardiac arrest, 14.2 {\%} had LBBB, NSIB or ST-depression.Conclusions: Several common ECG findings obtained from a primary care setting are associated with OHCA.",
keywords = "ECG, cardiac disease, out-of-hospital cardiac arrest, risk",
author = "S{\o}ndergaard, {Marc Meller} and Nielsen, {Jonas Bille} and Mortensen, {Rikke N{\o}rmark} and Gunnar Gislason and Lars K{\o}ber and Freddy Lippert and Claus Graff and Stig Hauns{\o} and Svendsen, {Jesper Hastrup} and Kragholm, {Kristian Hay} and Pietersen, {Adrian Holger} and Lind, {Bent Struer} and Hjortsh{\o}j, {S{\o}ren Pihlkj{\ae}r} and Holst, {Anders Gaarsdal} and Struijk, {Johannes Jan} and Christian Torp-Pedersen and Hansen, {Steen M{\o}ller}",
year = "2019",
month = "5",
day = "1",
doi = "10.1136/openhrt-2018-000905",
language = "English",
volume = "6",
pages = "e000905",
journal = "Open Heart",
issn = "2053-3624",
publisher = "BMJ Publishing Group",
number = "1",

}

RIS

TY - JOUR

T1 - Associations between common ECG abnormalities and out-of-hospital cardiac arrest

AU - Søndergaard, Marc Meller

AU - Nielsen, Jonas Bille

AU - Mortensen, Rikke Nørmark

AU - Gislason, Gunnar

AU - Køber, Lars

AU - Lippert, Freddy

AU - Graff, Claus

AU - Haunsø, Stig

AU - Svendsen, Jesper Hastrup

AU - Kragholm, Kristian Hay

AU - Pietersen, Adrian Holger

AU - Lind, Bent Struer

AU - Hjortshøj, Søren Pihlkjær

AU - Holst, Anders Gaarsdal

AU - Struijk, Johannes Jan

AU - Torp-Pedersen, Christian

AU - Hansen, Steen Møller

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Background: Out-of-hospital cardiac arrest (OHCA) is often the first manifestation of unrecognised cardiac disease. ECG abnormalities encountered in primary care settings may be warning signs of OHCA.Objective: We examined the association between common ECG abnormalities and OHCA in a primary care setting.Methods: We cross-linked individuals who had an ECG recording between 2001 and 2011 in a primary care setting with the Danish Cardiac Arrest Registry and identified OHCAs of presumed cardiac cause.Results: A total of 326 227 individuals were included and 2667 (0,8%) suffered an OHCA. In Cox regression analyses, adjusted for age and sex, the following ECG findings were strongly associated with OHCA: ST-depression without concomitant atrial fibrillation (HR 2.79; 95% CI 2.45 to 3.18), left bundle branch block (LBBB; HR 3.44; 95% CI 2.85 to 4.14) and non-specific intraventricular block (NSIB; HR 3.15; 95% CI 2.58 to 3.83). Also associated with OHCA were atrial fibrillation (HR 1.89; 95% CI 1.63 to 2.18), Q-wave (HR 1.75; 95% CI 1.57 to 1.95), Cornell and Sokolow-Lyon criteria for left ventricular hypertrophy (HR 1.56; 95% CI 1.33 to 1.82 and HR 1.27; 95% CI 1.12 to 1.45, respectively), ST-elevation (HR 1.40; 95% CI 1.09 to 1.54) and right bundle branch block (HR 1.29; 95% CI 1.09 to 1.54). The association between ST-depression and OHCA diminished with concomitant atrial fibrillation (HR 1.79; 95% CI 1.42 to 2.24, p < 0.01 for interaction). Among patients suffering from OHCA, without a known cardiac disease at the time of the cardiac arrest, 14.2 % had LBBB, NSIB or ST-depression.Conclusions: Several common ECG findings obtained from a primary care setting are associated with OHCA.

AB - Background: Out-of-hospital cardiac arrest (OHCA) is often the first manifestation of unrecognised cardiac disease. ECG abnormalities encountered in primary care settings may be warning signs of OHCA.Objective: We examined the association between common ECG abnormalities and OHCA in a primary care setting.Methods: We cross-linked individuals who had an ECG recording between 2001 and 2011 in a primary care setting with the Danish Cardiac Arrest Registry and identified OHCAs of presumed cardiac cause.Results: A total of 326 227 individuals were included and 2667 (0,8%) suffered an OHCA. In Cox regression analyses, adjusted for age and sex, the following ECG findings were strongly associated with OHCA: ST-depression without concomitant atrial fibrillation (HR 2.79; 95% CI 2.45 to 3.18), left bundle branch block (LBBB; HR 3.44; 95% CI 2.85 to 4.14) and non-specific intraventricular block (NSIB; HR 3.15; 95% CI 2.58 to 3.83). Also associated with OHCA were atrial fibrillation (HR 1.89; 95% CI 1.63 to 2.18), Q-wave (HR 1.75; 95% CI 1.57 to 1.95), Cornell and Sokolow-Lyon criteria for left ventricular hypertrophy (HR 1.56; 95% CI 1.33 to 1.82 and HR 1.27; 95% CI 1.12 to 1.45, respectively), ST-elevation (HR 1.40; 95% CI 1.09 to 1.54) and right bundle branch block (HR 1.29; 95% CI 1.09 to 1.54). The association between ST-depression and OHCA diminished with concomitant atrial fibrillation (HR 1.79; 95% CI 1.42 to 2.24, p < 0.01 for interaction). Among patients suffering from OHCA, without a known cardiac disease at the time of the cardiac arrest, 14.2 % had LBBB, NSIB or ST-depression.Conclusions: Several common ECG findings obtained from a primary care setting are associated with OHCA.

KW - ECG

KW - cardiac disease

KW - out-of-hospital cardiac arrest

KW - risk

U2 - 10.1136/openhrt-2018-000905

DO - 10.1136/openhrt-2018-000905

M3 - Journal article

VL - 6

SP - e000905

JO - Open Heart

JF - Open Heart

SN - 2053-3624

IS - 1

M1 - e000905

ER -

ID: 57413985