Electrocardiographic Preexcitation and Risk of Cardiovascular Morbidity and Mortality: Results from the Copenhagen ECG Study
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Electrocardiographic Preexcitation and Risk of Cardiovascular Morbidity and Mortality : Results from the Copenhagen ECG Study. / Skov, Morten W.; Rasmussen, Peter V.; Ghouse, Jonas; Hansen, Steen M.; Graff, Claus; Olesen, Morten S.; Pietersen, Adrian; Torp-Pedersen, Christian; Haunsø, Stig; Køber, Lars; Svendsen, Jesper H.; Holst, Anders G.; Nielsen, Jonas B.
I: Circulation: Arrhythmia and Electrophysiology, Bind 10, Nr. 6, e004778, 06.2017.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Electrocardiographic Preexcitation and Risk of Cardiovascular Morbidity and Mortality
T2 - Results from the Copenhagen ECG Study
AU - Skov, Morten W.
AU - Rasmussen, Peter V.
AU - Ghouse, Jonas
AU - Hansen, Steen M.
AU - Graff, Claus
AU - Olesen, Morten S.
AU - Pietersen, Adrian
AU - Torp-Pedersen, Christian
AU - Haunsø, Stig
AU - Køber, Lars
AU - Svendsen, Jesper H.
AU - Holst, Anders G.
AU - Nielsen, Jonas B.
PY - 2017/6
Y1 - 2017/6
N2 - Background - The majority of available data on the clinical course of patients with ventricular preexcitation in the ECG originates from tertiary centers. We aimed to investigate long-term outcomes in individuals from a primary care population with electrocardiographic preexcitation. Methods and Results - Digital ECGs from 328 638 primary care patients were collected during 2001 to 2011. We identified 310 individuals with preexcitation (age range, 8-85 years). Data on medication, comorbidity, and outcomes were collected from Danish nationwide registries. The median follow-up time was 7.4 years (quartiles, 4.6-10.3 years). Compared with the remainder of the population, patients with preexcitation had higher adjusted hazards of atrial fibrillation (hazard ratio [HR], 3.12; 95% confidence interval [CI], 2.07-4.70) and heart failure (HR, 2.11; 95% CI, 1.27-3.50). Subgroup analysis on accessory pathway location revealed a higher adjusted hazard of heart failure for a right anteroseptal accessory pathway (HR, 5.88; 95% CI, 2.63-13.1). There was no evidence of a higher hazard of death among individuals with preexcitation when looking across all age groups (HR, 1.07; 95% CI, 0.68-1.68). However, a statistically significant (P=0.01) interaction analysis (<65 versus ≥65 years) indicated a higher hazard of death for patients with preexcitation ≥65 years (HR, 1.85; 95% CI, 1.07-3.18). Conclusions - In this large ECG study, individuals with preexcitation had higher hazards of atrial fibrillation and heart failure. The higher hazard of heart failure seemed to be driven by a right anteroseptal accessory pathway. Among elderly people, we found a statistically significant association between preexcitation and a higher hazard of death.
AB - Background - The majority of available data on the clinical course of patients with ventricular preexcitation in the ECG originates from tertiary centers. We aimed to investigate long-term outcomes in individuals from a primary care population with electrocardiographic preexcitation. Methods and Results - Digital ECGs from 328 638 primary care patients were collected during 2001 to 2011. We identified 310 individuals with preexcitation (age range, 8-85 years). Data on medication, comorbidity, and outcomes were collected from Danish nationwide registries. The median follow-up time was 7.4 years (quartiles, 4.6-10.3 years). Compared with the remainder of the population, patients with preexcitation had higher adjusted hazards of atrial fibrillation (hazard ratio [HR], 3.12; 95% confidence interval [CI], 2.07-4.70) and heart failure (HR, 2.11; 95% CI, 1.27-3.50). Subgroup analysis on accessory pathway location revealed a higher adjusted hazard of heart failure for a right anteroseptal accessory pathway (HR, 5.88; 95% CI, 2.63-13.1). There was no evidence of a higher hazard of death among individuals with preexcitation when looking across all age groups (HR, 1.07; 95% CI, 0.68-1.68). However, a statistically significant (P=0.01) interaction analysis (<65 versus ≥65 years) indicated a higher hazard of death for patients with preexcitation ≥65 years (HR, 1.85; 95% CI, 1.07-3.18). Conclusions - In this large ECG study, individuals with preexcitation had higher hazards of atrial fibrillation and heart failure. The higher hazard of heart failure seemed to be driven by a right anteroseptal accessory pathway. Among elderly people, we found a statistically significant association between preexcitation and a higher hazard of death.
KW - atrial fibrillation
KW - death
KW - electrocardiography
KW - heart failure
KW - Wolff-Parkinson-White syndrome
U2 - 10.1161/CIRCEP.116.004778
DO - 10.1161/CIRCEP.116.004778
M3 - Journal article
C2 - 28576781
AN - SCOPUS:85021065225
VL - 10
JO - Circulation: Arrhythmia and Electrophysiology
JF - Circulation: Arrhythmia and Electrophysiology
SN - 1941-3149
IS - 6
M1 - e004778
ER -
ID: 189699812