Alteraciones mayores del electrocardiograma y riesgo cardiovascular en la población mediterránea de medio y alto riesgo
[Abstract] Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factor...
| Autores: | , , , , , , , , , , , , , |
|---|---|
| Formato: | artículo |
| Fecha de publicación: | 2024 |
| País: | España |
| Recursos: | Conselleria de Salut i Consum del Govern de les Illes Balears |
| Repositorio: | Docusalut |
| Idioma: | inglés |
| OAI Identifier: | oai:docusalut.com:20.500.13003/21524 |
| Acesso em linha: | https://hdl.handle.net/20.500.13003/21524 |
| Access Level: | acceso abierto |
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Alteraciones mayores del electrocardiograma y riesgo cardiovascular en la población mediterránea de medio y alto riesgo Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population |
| title |
Alteraciones mayores del electrocardiograma y riesgo cardiovascular en la población mediterránea de medio y alto riesgo |
| spellingShingle |
Alteraciones mayores del electrocardiograma y riesgo cardiovascular en la población mediterránea de medio y alto riesgo Pou Bordoy, Joan |
| title_short |
Alteraciones mayores del electrocardiograma y riesgo cardiovascular en la población mediterránea de medio y alto riesgo |
| title_full |
Alteraciones mayores del electrocardiograma y riesgo cardiovascular en la población mediterránea de medio y alto riesgo |
| title_fullStr |
Alteraciones mayores del electrocardiograma y riesgo cardiovascular en la población mediterránea de medio y alto riesgo |
| title_full_unstemmed |
Alteraciones mayores del electrocardiograma y riesgo cardiovascular en la población mediterránea de medio y alto riesgo |
| title_sort |
Alteraciones mayores del electrocardiograma y riesgo cardiovascular en la población mediterránea de medio y alto riesgo |
| dc.creator.none.fl_str_mv |
Pou Bordoy, Joan Leiva, Alfonso Albendín Ariza, María José Elosua, Roberto Rigo Carratala, Fernando Romaguera, Dora Salas-Salvadó, Jordi Babio, Nancy Martinez-González, Miguel Angel Toledo, Estefanía Fitó, Montserrat Aros, Fernando Estruch, Ramon Fiol Sala, Miquel |
| author |
Pou Bordoy, Joan |
| author_facet |
Pou Bordoy, Joan Leiva, Alfonso Albendín Ariza, María José Elosua, Roberto Rigo Carratala, Fernando Romaguera, Dora Salas-Salvadó, Jordi Babio, Nancy Martinez-González, Miguel Angel Toledo, Estefanía Fitó, Montserrat Aros, Fernando Estruch, Ramon Fiol Sala, Miquel |
| author_role |
author |
| author2 |
Leiva, Alfonso Albendín Ariza, María José Elosua, Roberto Rigo Carratala, Fernando Romaguera, Dora Salas-Salvadó, Jordi Babio, Nancy Martinez-González, Miguel Angel Toledo, Estefanía Fitó, Montserrat Aros, Fernando Estruch, Ramon Fiol Sala, Miquel |
| author2_role |
author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
|
| description |
[Abstract] Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO). 1.752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel's C Indices, Nam d'Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated. At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51-58.03, pvalor<.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38-4.21, pvalor=.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76-18.72, pvalor=.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36-7.71, pvalor<.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed. MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors. |
| publishDate |
2024 |
| dc.date.none.fl_str_mv |
2024 2024-12-19 2024 2024-12-19 |
| dc.type.none.fl_str_mv |
research article http://purl.org/coar/resource_type/c_2df8fbb1 |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
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article |
| dc.identifier.none.fl_str_mv |
https://hdl.handle.net/20.500.13003/21524 |
| url |
https://hdl.handle.net/20.500.13003/21524 |
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Inglés eng |
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Inglés |
| language |
eng |
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open access http://purl.org/coar/access_right/c_abf2 |
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info:eu-repo/semantics/openAccess |
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open access http://purl.org/coar/access_right/c_abf2 |
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openAccess |
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application/pdf |
| dc.publisher.none.fl_str_mv |
Elsevier |
| publisher.none.fl_str_mv |
Elsevier |
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reponame:Docusalut instname:Conselleria de Salut i Consum del Govern de les Illes Balears |
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Conselleria de Salut i Consum del Govern de les Illes Balears |
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Docusalut |
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Docusalut |
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1869403523896049664 |
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Alteraciones mayores del electrocardiograma y riesgo cardiovascular en la población mediterránea de medio y alto riesgoMajor abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean populationPou Bordoy, JoanLeiva, AlfonsoAlbendín Ariza, María JoséElosua, RobertoRigo Carratala, FernandoRomaguera, DoraSalas-Salvadó, JordiBabio, NancyMartinez-González, Miguel AngelToledo, EstefaníaFitó, MontserratAros, FernandoEstruch, RamonFiol Sala, Miquel[Abstract] Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO). 1.752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel's C Indices, Nam d'Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated. At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51-58.03, pvalor<.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38-4.21, pvalor=.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76-18.72, pvalor=.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36-7.71, pvalor<.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed. MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors.[Resum] Introducción Las alteraciones mayores del electrocardiograma (AMECG) son frecuentes en personas de mediana y avanzada edad, y podrían ser un factor importante en la predicción de eventos cardiovasculares (ECV). Objetivo Analizar la asociación entre AMECG (clasificación de Minnesota) y ECV independientemente de los factores de riesgo cardiovascular (FRCV) clásicos y valorar si mejoran la predicción de la función de riesgo FRESCO-Función de Riesgo Española de Acontecimientos Coronarios. Método Se incluyeron 1.752 participantes del estudio PREDIMED entre 55 y 80 años con RCV medio o alto, con una media de seguimiento de 5,1 años. Durante el periodo de seguimiento se ha estimado la incidencia acumulada de ECV por sexo y presencia de AMECG, y analizado la asociación entre AMECG y ECV mediante regresión multivariante de Cox ajustadas por grupo de aleatorización y RCV (FRESCO). Para analizar la mejora en la predicción se calcularon los índices C de Harrel's, Nam d’Agostino, Net Reclassification Improvement e Integrated Discrimination Improvement . Resultados Al inicio del estudio, un 25% de los participantes presentaron AMECG. Durante el seguimiento aparecieron 112 ECV (16 muertes cardiovasculares, 15 infartos agudo de miocardio, 38 anginas, 43 accidentes cerebrovasculares). Las AEMCG se asociaron a una mayor probabilidad de sufrir un ECV. En varones, las principales AMECG asociadas a la aparición de ECV fueron los criterios de hipertrofia de ventrículo izquierdo (HVE) con inversión de onda T (HR: 17,88; IC 95%: 5,51-58,03; p valor < 0,001) y el alargamiento de QT (HR: 2,41; IC 95%: 1,38-4,21; p valor = 0,002), y en mujeres la fibrilación auricular (HR: 5,7; IC 95%: 1,76-18,72; p valor = 0,006) y el descenso del ST (HR: 3,24; IC 95%: 1,36-7,71; p valor < 0,001). No se observó mejoría significativa en la capacidad predictiva de FRESCO al introducir las AMECG. Conclusiones Las AMECG se asocian de manera independiente con los ECV, por lo que deben ser consideradas durante el curso del proceso clínico. Sin embargo, no ofrece una mejora adicional en la predicción del riesgo cardiovascular a la proporcionada por los factores de riesgo clásicos.Elsevier20242024-12-1920242024-12-19research articlehttp://purl.org/coar/resource_type/c_2df8fbb1info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.13003/21524reponame:Docusalutinstname:Conselleria de Salut i Consum del Govern de les Illes BalearsInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:docusalut.com:20.500.13003/215242026-06-22T12:44:07Z |
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15.812429 |