1. Frequency of Electrocardiogram-Defined Cardiac Conduction Disorders in a Multi-Institutional Primary Care Cohort.
- Author
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Haimovich JS, Di Achille P, Nauffal V, Singh P, Reeder C, Wang X, Sarma G, Kornej J, Benjamin EJ, Philippakis A, Batra P, Ellinor PT, Lubitz SA, and Khurshid S
- Abstract
Background: Disorders affecting cardiac conduction are associated with substantial morbidity. Understanding the epidemiology and risk factors for conduction disorders may enable earlier diagnosis and preventive efforts., Objectives: The purpose of this study was to quantify contemporary frequency and risk factors for electrocardiogram (ECG)-defined cardiac conduction disorders in a large multi-institutional primary care sample., Methods: We quantified prevalence and incidence of conduction disorders among adults receiving longitudinal primary care between 2001 and 2019, each with at least one 12-lead ECG performed prior to the start of follow-up and at least one ECG during follow-up. We defined conduction disorders using curated terms extracted from ECG diagnostic statements by cardiologists. We grouped conduction disorders by inferred anatomic location of abnormal conduction. We tested associations between clinical factors and incident conduction disease using multivariable proportional hazards regression., Results: We analyzed 189,163 individuals (median age 55 years; 58% female). The overall prevalence of conduction disorders was 27% among men and 15% among women. Among 119,926 individuals (median age 55 years; 51% female), 6,802 developed an incident conduction system abnormality over a median of 10 years (Q1, Q3: 6, 15 years) of follow-up. Incident conduction disorders were more common in men (8.78 events/1,000 person-years) vs women (4.34 events/1,000 person-years, P < 0.05). In multivariable models, clinical factors including older age (HR: 1.25 per 5-year increase [95% CI: 1.24-1.26]) and myocardial infarction (HR: 1.39 [95% CI: 1.26-1.54]) were associated with incident conduction disorders., Conclusions: Cardiac conduction disorders are common in a primary care population, especially among older individuals with cardiovascular risk factors., Competing Interests: Dr Lubitz is a full-time employee of Novartis as of July 2022. He received sponsored research support from Bristol Myers Squibb, Pfizer, Boehringer Ingelheim, Fitbit, Medtronic, Premier, and IBM, and has consulted for Bristol Myers Squibb, Pfizer, Blackstone Life Sciences, and Invitae. Dr Ellinor receives sponsored research support from Bayer AG and IBM and has consulted for Novartis, MyoKardia, and Bayer AG. Dr Ho has received sponsored research support from Bayer AG. Dr Batra receives sponsored research support from Bayer AG and IBM and has consulted for Novartis and Prometheus Biosciences. Dr Philippakis is a Venture Partners and employee at GV, has consulted for Novartis and Rakuten, and receives sponsored research support from Verily, Microsoft, IBM, Intel, Pfizer, Abbvie, Biogen, Ionnis and Bayer. Investigators were supported by 10.13039/100000002National Institutes of Health grants K23HL169839-01 (Dr Khurshid), R38HL150212 (Dr Haimovich); R01HL139731 (Dr Lubitz), R01HL157635 (Dr Lubitz), R01HL134893 (Dr Ho), R01HL140224 (Dr Ho), K24HL153669 (Dr Ho), 2R01HL092577 (Dr Ellinor), and 1R01AG066010, R01HL092577 (Dr Benjamin); 10.13039/100000968American Heart Association grants 18SFRN34250007 (Dr Lubitz), AF 18SFRN34110082 (Dr Benjamin), 2023CDA1050571 (Dr Khurshid) and 18SFRN34110082 (Dr Ellinor); and by a grant from the European Union, MAESTRIA 965286 (Dr Ellinor). Dr Kornej has received funding from the 10.13039/100018694Marie Sklodowska-Curie Actions under the European Union’s 10.13039/100010661Horizon 2020 research and innovation programme (Agreement No 838259). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)
- Published
- 2024
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