Prognostic value of the computerized ECG in Hispanics

Pérez, Marco; Yaw, Tan Swee; Myers, Jonathan; Froelicher, Victor

doi:10.1002/clc.20053

Cited by 18 publications

(14 citation statements)

References 15 publications

(14 reference statements)

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“…Previous studies in veteran male populations where different race groups had similar access to healthcare reported similar findings 25 26. These differences persist despite adjustment for socioeconomic factors.…”

Section: Discussionsupporting

confidence: 63%

Risk factors for atrial fibrillation and their population burden in postmenopausal women: the Women's Health Initiative Observational Study

Pérez

Wang

Larson

et al. 2013

Heart

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Objective Atrial fibrillation (AF) is the most common arrhythmia in women. Large studies evaluating key AF risk factors in older women are lacking. We aimed to identify risk factors for AF in postmenopausal women and measure population burden of modifiable risk factors. Design Prospective observational study. Setting The Women's Health Initiative (WHI) Observational Study. Patients 93 676 postmenopausal women were followed for an average of 9.8 years for cardiovascular outcomes. After exclusion of women with prevalent AF or incomplete data, 8252 of the remaining 81 892 women developed incident AF. Main outcome measures Incident AF was identified by WHI-ascertained hospitalisation records and diagnosis codes from Medicare claims. Multivariate Cox hazard regression analysis identified independent risk factors for incident AF. Results Age, hypertension, obesity, diabetes, myocardial infarction and heart failure were independently associated with incident AF. Hypertension and overweight status accounted for 28.3% and 12.1%, respectively, of the population attributable risk. Hispanic and African-American participants had lower rates of incident AF (HR 0.58, 95% CI 0.47 to 0.70 and HR 0.59, 95% CI 0.53 to 0.65, respectively) than Caucasians. Conclusions Caucasian ethnicity, traditional cardiovascular risk factors and peripheral arterial disease were independently associated with higher rates of incident AF in postmenopausal women. Hypertension and overweight status accounted for a large proportion of population attributable risk. Measuring burden of modifiable AF risk factors in older women may help target interventions.

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Section: Discussionsupporting

confidence: 63%

Risk factors for atrial fibrillation and their population burden in postmenopausal women: the Women's Health Initiative Observational Study

Pérez

Wang

Larson

et al. 2013

Heart

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“…A study of over 44,000 ECGs reported lower prevalence of ECG markers of coronary heart disease, atrial fibrillation, and left ventricular hypertrophy in Hispanics, compared with non-Hispanics. 22 However, ECG abnormalities included in that study conferred an approximately 2-fold increase in risk of cardiovascular death, which was similar to that of the non-Hispanic subgroup. At first glance, these findings contradict our observation of no difference in the prevalence of minor isolated Q waves among races/ethnicities, and that minor isolated Q waves carry prognostic significance in Hispanics but not other races/ethnicities.…”

Section: Discussionmentioning

confidence: 51%

Minor Isolated Q Waves and Cardiovascular Events in the MESA Study

Dawood

Chen

et al. 2013

The American Journal of Medicine

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BACKGROUND The significance of minor isolated Q waves in the resting electrocardiograms (ECGs) of apparently healthy individuals is unknown. OBJECTIVE To examine the association between minor isolated Q waves and incident cardiovascular disease events in the Multi-Ethnic Study of Atherosclerosis (MESA). DESIGN This analysis included 6551 MESA participants (38% white, 28% black, 22% Hispanic, 12% Chinese) who were free of cardiovascular disease at enrollment. Cox proportional hazards models were used to examine the association between minor isolated Q waves defined by the Minnesota ECG Classification with adjudicated incident cardiovascular events. RESULTS During up to 7.8 years of follow-up, 423 events occurred, with a rate of 10.7 events per 1000 person-years. A significant interaction between minor isolated Q waves and race/ethnicity was observed (P = .030). In models stratified by race/ethnicity and adjusted for demographics, socioeconomic status, common cardiovascular risk factors, and other ECG abnormalities, presence of isolated minor Q waves was significantly associated with incident cardiovascular events in Hispanics (hazard ratio [HR] 2.62; 95% confidence interval [CI], 1.42-4.82), but not in whites (HR 0.65; 95% CI, 0.32-1.33) or blacks (HR 1.46; 95% CI, 0.74-2.89). Despite the statistically significant association in the Chinese population, the small number of events precluded solid conclusions in this race/ethnicity. CONCLUSION The prognostic significance of minor isolated Q waves varies across races/ethnicities; they carry a high risk for future cardiovascular events in apparently healthy Hispanics, but not in whites or blacks.

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“…Studies reporting a reduced risk of AF among non-white races have been limited by the use of a single non-white comparator group, [4][5][6][13][14][15][16] absence of incident event data, [3][4][5][16][17][18][19] failure to adjust for comorbidities, 3,17,18 or enrollment of select populations (including patients with acute decompensated heart failure, 4 with acute myocardial infarction, 14 on hemodialysis, 20 and after coronary artery bypass graft surgery). 21 Our results provide a more comprehensive assessment of the risk of AF among a diverse population of patients seeking care at California hospitals without limitation to a specific disease condition.…”

Section: Discussionmentioning

confidence: 99%