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Electrocardiogram abnormalities and cardiovascular mortality in elderly patients with CKD.
Clin J Am Soc Nephrol. 2012 Jun; 7(6):949-56.CJ

Abstract

BACKGROUND AND OBJECTIVES

Cardiovascular disease is the most common cause of death in CKD. This study evaluated whether electrocardiogram (ECG) abnormalities are predictors of cardiovascular death in CKD.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

The Cardiovascular Health Study limited database (1989-2005) was used to identify a cohort with CKD at baseline (estimated GFR < 60 mL/min per 1.73 m(2)). The patients were categorized as having major, minor, or no ECG abnormalities. Rates of adjudicated cardiovascular events and mortality were compared among the groups using proportional hazards regression models.

RESULTS

A total of 1192 participants had CKD at baseline; mean age ± SD was 74.7±6.2 years. Of these patients, 452 (38.8%) had major, 346 (29.7%) had minor, and 367 (31.5%) had no ECG abnormalities. Participants with estimated GFR < 60 mL/min per 1.73 m(2) were more likely to have ECG abnormalities at baseline (adjusted prevalence odds ratio, 1.23 [95% confidence interval (CI), 1.06-1.43]) than those with GFR ≥ 60 mL/min per 1.73 m(2). During mean follow-up of 10.3±3.8 years, 814 (68.3%) participants died. Compared with participants without ECG abnormalities, participants with major abnormalities had the highest risk for cardiovascular events and death; adjusted hazard ratios were 2.15 (95% CI, 1.56-2.98) and 2.27 (95% CI, 1.56-3.30), respectively. For minor ECG abnormalities, hazard ratios were 1.24 (95% CI, 0.91-1.70) and 1.48 (95% CI, 1.00-2.18), respectively.

CONCLUSIONS

In patients with CKD, major ECG abnormalities are frequently present and predict a significantly higher risk for death and adverse cardiovascular outcomes.

Authors+Show Affiliations

Division of Nephrology and Hypertension, Case Western Reserve University, Cleveland, Ohio, USA. mirela.dobre@uhhospitals.orgNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22461533

Citation

Dobre, Mirela, et al. "Electrocardiogram Abnormalities and Cardiovascular Mortality in Elderly Patients With CKD." Clinical Journal of the American Society of Nephrology : CJASN, vol. 7, no. 6, 2012, pp. 949-56.
Dobre M, Brateanu A, Rashidi A, et al. Electrocardiogram abnormalities and cardiovascular mortality in elderly patients with CKD. Clin J Am Soc Nephrol. 2012;7(6):949-56.
Dobre, M., Brateanu, A., Rashidi, A., & Rahman, M. (2012). Electrocardiogram abnormalities and cardiovascular mortality in elderly patients with CKD. Clinical Journal of the American Society of Nephrology : CJASN, 7(6), 949-56. https://doi.org/10.2215/CJN.07440711
Dobre M, et al. Electrocardiogram Abnormalities and Cardiovascular Mortality in Elderly Patients With CKD. Clin J Am Soc Nephrol. 2012;7(6):949-56. PubMed PMID: 22461533.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Electrocardiogram abnormalities and cardiovascular mortality in elderly patients with CKD. AU - Dobre,Mirela, AU - Brateanu,Andrei, AU - Rashidi,Arash, AU - Rahman,Mahboob, Y1 - 2012/03/29/ PY - 2012/3/31/entrez PY - 2012/3/31/pubmed PY - 2012/10/17/medline SP - 949 EP - 56 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 7 IS - 6 N2 - BACKGROUND AND OBJECTIVES: Cardiovascular disease is the most common cause of death in CKD. This study evaluated whether electrocardiogram (ECG) abnormalities are predictors of cardiovascular death in CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Cardiovascular Health Study limited database (1989-2005) was used to identify a cohort with CKD at baseline (estimated GFR < 60 mL/min per 1.73 m(2)). The patients were categorized as having major, minor, or no ECG abnormalities. Rates of adjudicated cardiovascular events and mortality were compared among the groups using proportional hazards regression models. RESULTS: A total of 1192 participants had CKD at baseline; mean age ± SD was 74.7±6.2 years. Of these patients, 452 (38.8%) had major, 346 (29.7%) had minor, and 367 (31.5%) had no ECG abnormalities. Participants with estimated GFR < 60 mL/min per 1.73 m(2) were more likely to have ECG abnormalities at baseline (adjusted prevalence odds ratio, 1.23 [95% confidence interval (CI), 1.06-1.43]) than those with GFR ≥ 60 mL/min per 1.73 m(2). During mean follow-up of 10.3±3.8 years, 814 (68.3%) participants died. Compared with participants without ECG abnormalities, participants with major abnormalities had the highest risk for cardiovascular events and death; adjusted hazard ratios were 2.15 (95% CI, 1.56-2.98) and 2.27 (95% CI, 1.56-3.30), respectively. For minor ECG abnormalities, hazard ratios were 1.24 (95% CI, 0.91-1.70) and 1.48 (95% CI, 1.00-2.18), respectively. CONCLUSIONS: In patients with CKD, major ECG abnormalities are frequently present and predict a significantly higher risk for death and adverse cardiovascular outcomes. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/22461533/Electrocardiogram_abnormalities_and_cardiovascular_mortality_in_elderly_patients_with_CKD_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=22461533 DB - PRIME DP - Unbound Medicine ER -