國家衛生研究院 NHRI:Item 3990099045/13768
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/13768


    Title: Develop and apply electrocardiography-based risk score to identify community-based elderly individuals at high-risk of mortality
    Authors: Lu, TP;Chattopadhyay, A;Lu, KC;Chuang, JY;Yeh, SS;Chang, IS;Chen, CJ;Wu, IC;Hsu, CC;Chen, TY;Tseng, WT;Hsiung, CA;Juang, JJ
    Contributors: Institute of Population Health Sciences
    Abstract: With an aging world population, risk stratification of community-based, elderly population is required for primary prevention. This study proposes a combined score developed using electrocardiographic (ECG) parameters and determines its long-term prognostic value for predicting risk of cardiovascular mortality. A cohort-study, conducted from December 2008 to April 2019, enrolled 5,380 subjects in Taiwan, who were examined, using three-serial-12-lead ECGs, and their health/demographic information were recorded. To understand the predictive effects of ECG parameters on overall-survival, Cox hazard regression analysis were performed. The mean age at enrollment was 69.04 ± 8.14 years, and 47.4% were males. ECG abnormalities, LVH [hazard ratio (HR) = 1.39, 95% confidence intervals (CI) = (1.16-1.67), P = 0.0003], QTc [HR = 1.31, CI = (1.07-1.61), P = 0.007] and PR interval [HR = 1.40, CI = (1.01-1.95), P = 0.04], were significantly associated with primary outcome all-cause death. Furthermore, LVH [HR = 2.37, CI = (1.48-3.79), P = 0.0003] was significantly associated with cardiovascular death, while PR interval [HR = 2.63, CI = (1.24- 5.57), P = 0.01] with unexplained death. ECG abnormality (EA) score was defined based on the number of abnormal ECG parameters for each patient, which was used to divide all patients into sub-groups. Competing risk survival analysis using EA score were performed by using the Gray's test, which reported that high-risk EA groups showed significantly higher cumulative incidence for all three outcomes. Prognostic models using the EA score as predictor were developed and a 10-fold cross validation design was adopted to conduct calibration and discrimination analysis, to establish the efficacy of the proposed models. Overall, ECG model could successfully predict people, susceptible to all three death outcomes (P < 0.05), with high efficacy. Statistically significant (P < 0.001) improvement of the c-indices further demonstrated the robustness of the prediction model with ECG parameters, as opposed to a traditional model with no EA predictor. The EA score is highly associated with increased risk of mortality in elderly population and may be successfully used in clinical practice.
    Date: 2021-10-08
    Relation: Frontiers in Cardiovascular Medicine. 2021 Oct 8;8:Article number 738061.
    Link to: http://dx.doi.org/10.3389/fcvm.2021.738061
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=2297-055X&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000710939300001
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85126562623
    Appears in Collections:[Chao A. Hsiung] Periodical Articles
    [Chih-Cheng Hsu] Periodical Articles
    [I-Chien Wu] Periodical Articles
    [I-Shou Chang] Periodical Articles

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