Associations between common ECG abnormalities and out-of-hospital cardiac arrest
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 set...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-05-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/6/1/e000905.full |
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| author | Christian Torp-Pedersen Lars Køber Marc Meller Søndergaard Jonas Bille Nielsen Rikke Nørmark Mortensen Gunnar Gislason Freddy Lippert Claus Graff Stig Haunsø Jesper Hastrup Svendsen Kristian Hay Kragholm Adrian Holger Pietersen Bent Struer Lind Søren Pihlkjær Hjortshøj Anders Gaarsdal Holst Johannes Jan Struijk Steen Møller Hansen |
| author_facet | Christian Torp-Pedersen Lars Køber Marc Meller Søndergaard Jonas Bille Nielsen Rikke Nørmark Mortensen Gunnar Gislason Freddy Lippert Claus Graff Stig Haunsø Jesper Hastrup Svendsen Kristian Hay Kragholm Adrian Holger Pietersen Bent Struer Lind Søren Pihlkjær Hjortshøj Anders Gaarsdal Holst Johannes Jan Struijk Steen Møller Hansen |
| author_sort | Christian Torp-Pedersen |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-ca9a872892594a44ae32e41a136ccbe5 |
| institution | OA Journals |
| issn | 2053-3624 |
| language | English |
| publishDate | 2019-05-01 |
| publisher | BMJ Publishing Group |
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| series | Open Heart |
| spelling | doaj-art-ca9a872892594a44ae32e41a136ccbe52025-08-20T02:14:14ZengBMJ Publishing GroupOpen Heart2053-36242019-05-016110.1136/openhrt-2018-000905Associations between common ECG abnormalities and out-of-hospital cardiac arrestChristian Torp-Pedersen0Lars Køber1Marc Meller Søndergaard2Jonas Bille Nielsen3Rikke Nørmark Mortensen4Gunnar Gislason5Freddy Lippert6Claus Graff7Stig Haunsø8Jesper Hastrup Svendsen9Kristian Hay Kragholm10Adrian Holger Pietersen11Bent Struer Lind12Søren Pihlkjær Hjortshøj13Anders Gaarsdal Holst14Johannes Jan Struijk15Steen Møller Hansen16Public Health, University of Copenhagen, Copenhagen, DenmarkDepartment of Cardiology, Rigshospitalet, Copenhagen, DenmarkDepartment of Clinical Epidemiology, Aalborg Universitetshospital, Aalborg, DenmarkDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USADepartment of Clinical Epidemiology, Aalborg Universitetshospital, Aalborg, DenmarkNational Institute of Public Health, University of Southern Denmark, Odense, Syddanmark, DenmarkDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkDepartment of Health Science and Technology, Aalborg University, Aalborg, DenmarkDepartment of Cardiology, Rigshospitalet, Kobenhavn, DenmarkDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkDepartment of Cardiology, Regional Hospital North Jutland, Hjorring, DenmarkDepartment of Cardiology, Nephrology and Endocrinology, Nordsjaellands Hospital, Hillerod, DenmarkDepartment of Clinical Biochemistry, Hvidovre Hospital, Hvidovre, DenmarkDepartment of Cardiology, Aalborg Universitetshospital, Aalborg, DenmarkLaboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, Kobenhavn, DenmarkDepartment of Health, Science and Technology, Aalborg Universitet Det Sundhedsvidenskabelige Fakultet, Aalborg, DenmarkDepartment of Clinical Epidemiology, Aalborg Universitetshospital, Aalborg, DenmarkBackground 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.https://openheart.bmj.com/content/6/1/e000905.full |
| spellingShingle | Christian Torp-Pedersen Lars Køber Marc Meller Søndergaard Jonas Bille Nielsen Rikke Nørmark Mortensen Gunnar Gislason Freddy Lippert Claus Graff Stig Haunsø Jesper Hastrup Svendsen Kristian Hay Kragholm Adrian Holger Pietersen Bent Struer Lind Søren Pihlkjær Hjortshøj Anders Gaarsdal Holst Johannes Jan Struijk Steen Møller Hansen Associations between common ECG abnormalities and out-of-hospital cardiac arrest Open Heart |
| title | Associations between common ECG abnormalities and out-of-hospital cardiac arrest |
| title_full | Associations between common ECG abnormalities and out-of-hospital cardiac arrest |
| title_fullStr | Associations between common ECG abnormalities and out-of-hospital cardiac arrest |
| title_full_unstemmed | Associations between common ECG abnormalities and out-of-hospital cardiac arrest |
| title_short | Associations between common ECG abnormalities and out-of-hospital cardiac arrest |
| title_sort | associations between common ecg abnormalities and out of hospital cardiac arrest |
| url | https://openheart.bmj.com/content/6/1/e000905.full |
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