Associations between common ECG abnormalities and out-of-hospital cardiac arrest
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Associations between common ECG abnormalities and out-of-hospital cardiac arrest. / Søndergaard, Marc Meller; Nielsen, Jonas Bille; Mortensen, Rikke Nørmark; Gislason, Gunnar; Køber, Lars; Lippert, Freddy; Graff, Claus; Haunsø, Stig; Svendsen, Jesper Hastrup; Kragholm, Kristian Hay; Pietersen, Adrian Holger; Lind, Bent Struer; Hjortshøj, Søren Pihlkjær; Holst, Anders Gaarsdal; Struijk, Johannes Jan; Torp-Pedersen, Christian; Hansen, Steen Møller.
I: Open Heart, Bind 6, Nr. 1, e000905, 2019.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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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
Y1 - 2019
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.
U2 - 10.1136/openhrt-2018-000905
DO - 10.1136/openhrt-2018-000905
M3 - Journal article
C2 - 31217990
VL - 6
JO - Open Heart
JF - Open Heart
SN - 2398-595X
IS - 1
M1 - e000905
ER -
ID: 224387935