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Titolo:
CLINICALLY SILENT ELECTROCARDIOGRAPHIC ABNORMALITIES AND RISK OF PRIMARY CARDIAC-ARREST AMONG HYPERTENSIVE PATIENTS
Autore:
SISCOVICK DS; RAGHUNATHAN TE; RAUTAHARJU P; PSATY BM; COBB LA; WAGNER EH;
Indirizzi:
UNIV WASHINGTON,CARDIOVASC HLTH RES UNIT,METROPOLITAN PK 2 BLDG,SUITE1360 SEATTLE WA 98101 UNIV WASHINGTON,DEPT EPIDEMIOL SEATTLE WA 98195 UNIV WASHINGTON,DEPT MED SEATTLE WA 00000 UNIV WASHINGTON,DEPT HLTH SERV SEATTLE WA 98195 UNIV MICHIGAN,INST SOCIAL RES ANN ARBOR MI 00000 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT PUBL HLTH SCI WINSTON SALEMNC 27103 GRP HLTH COOPERAT PUGET SOUND,CTR HLTH STUDIES SEATTLE WA 00000
Titolo Testata:
Circulation
fascicolo: 6, volume: 94, anno: 1996,
pagine: 1329 - 1333
SICI:
0009-7322(1996)94:6<1329:CSEAAR>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR MASS; PREDICTION; DISEASE; DEATH; HEART;
Keywords:
DEATH, SUDDEN; ELECTROCARDIOGRAPHY; EPIDEMIOLOGY; HEART ARREST; HYPERTENSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
16
Recensione:
Indirizzi per estratti:
Citazione:
D.S. Siscovick et al., "CLINICALLY SILENT ELECTROCARDIOGRAPHIC ABNORMALITIES AND RISK OF PRIMARY CARDIAC-ARREST AMONG HYPERTENSIVE PATIENTS", Circulation, 94(6), 1996, pp. 1329-1333

Abstract

Background Whether continuous ECG indexes that reflect the severity of left ventricular hypertrophy (LVHI), myocardial injury (CIIS), and QT-interval prolongation (QTI) are associated with the risk of primary cardiac arrest among hypertensive patients, independent of conventional binary ECG criteria, remains unknown. Methods and Results We conducted a population-based case-control study among patients who were free of clinically recognized heart disease and who received care at a health maintenance organization. Cases (n=131) were treated hypertensive patients who had had a primary cardiac arrest between 1977 and 1990. Controls (n=562) were a stratified random sample of treated hypertensivepatients. Resting ECGs were reviewed to estimate the severity of leftventricular hypertrophy, myocardial injury, and QT-interval prolongation on the basis of the algorithms of the Novacode ECG classification system. After adjustment for other risk factors and binary ECG criteria for the abnormalities, the LVHI, CIIS, and QTI scores were directly related to the risk of primary cardiac arrest. In a comparison of the 80th with the 20th percentile score for the LVHI, the risk was in creased 40% (odds ratio, 1.4; 95% CI, 1.0 to 2.0); for the CIIS, the risk was increased 70% (odds ratio, 1.7; 95% CI, 1.2 to 2.5); and for the QTI, the risk was increased 80% (odds ratio, 1.8; 95% CI, 1.3 to 2.7). Conclusions Our findings suggest that continuous ECG indexes that reflect left ventricular hypertrophy, myocardial injury, and QT-interval prolongation are directly related to the risk of primary cardiac arrestamong hypertensive patients without clinically recognized heart disease. Binary ECG criteria may underestimate the prognostic importance ofthese pathophysiological abnormalities.

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Documento generato il 24/11/20 alle ore 07:37:34