Abstract 18423: Associations Between Common ECG Findings and Out-of-Hospital Cardiac Arrest in a Primary Care Setting
Introduction: Out-of-hospital cardiac arrest (OHCA) is often the first manifestation of previously unrecognized cardiac disease. Electrocardiogram (ECG) abnormalities encountered in primary care settings may by warning signs of an increased risk of OHCA.
Hypothesis: 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 primary care with the Danish Cardiac Arrest Register and identified OHCAs of presumed cardiac cause. Multivariable cause-specific Cox regression was used to estimate the association between the ECG abnormalities and OHCA and calculate the absolute 10-year risk of OHCA for men and women with and without known cardiac disease for different age groupings, with age 70 shown as an example.
Results: A total of 326,227 individuals were included in the study and of those 2,667 suffered an OHCA during a median follow-up of 4 years. The following ECG findings were strongly associated with OHCA: ST-depression without atrial fibrillation (AF), left bundle branch block, and non-specific intraventricular block (Figure). For 70-year old men without cardiac disease, the presence of ST-depression, left bundle branch block, or non-specific intraventricular block posed an increased 10-year risk of OHCA compared with none of them being present (4.4% [95%CI 3.9-5.1%] vs. 2.1% [95%CI 1.9-2.3%], 5.4% [95%CI 4.6-6.5%] vs. 2.1% [95%CI 2.0-2.2%], and 5.4% [95%CI 4.4-6.2%] vs. 2.1% [95%CI 1.9-2.2%], respectively). Women had approximately half the 10-year risk of men. For OHCA patients without a known cardiac disease at the time of the OHCA event (1,352 of 2,667 patients), 14.2% (192) had one of the three high-risk ECG abnormalities.
Conclusions: Several common ECG abnormalities are associated with OHCA, especially left bundle branch block, non-specific intraventricular block, and ST-depression without atrial fibrillation.
Author Disclosures: S.M. Hansen: None. J.B. Nielsen: None. R. Mortensen: None. G. Gislason: Research Grant; Modest; Bristol-Myers Squibb, Pfizer, AtraZeneca, Bayer, Boehringer Ingelheim. L. Køber: Honoraria; Modest; Novartis, Sanofy. F. Lippert: None. C. Graff: None. S. Haunsø: None. J.H. Svendsen: Research Grant; Modest; Medtronic, Gilead. Honoraria; Modest; Medtronic, AstraZeneca, Boehringer Ingelheim. Consultant/Advisory Board; Modest; Medtronic. K. Kragholm: None. A. Pietersen: None. B. Lind: None. S. Hjortshøj: None. A.G. Holst: Employment; Significant; Novo Nordisk A/S. J.J. Struijk: None. C. Torp-Pedersen: Research Grant; Modest; Bristol-Myers Squibb. Consultant/Advisory Board; Modest; Cardiome, Merck, Sanofi, Daiichi.
- © 2016 by American Heart Association, Inc.