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Associations between primary care electrocardiography and non-Alzheimer dementia.
- Source :
- Journal of Stroke & Cerebrovascular Diseases; Sep2022, Vol. 31 Issue 9, pN.PAG-N.PAG, 1p
- Publication Year :
- 2022
-
Abstract
- <bold>Objectives: </bold>To determine whether electrocardiogram (ECG) markers are associated with incident non-Alzheimer's dementia (non-AD) and whether these markers also improve risk prediction for non-AD.<bold>Materials and Methods: </bold>We retrospectively included 170,605 primary care patients aged 60 years or older referred for an ECG by their general practitioner and followed them for a median of 7.6 years. Using Cox regression, we reported hazard ratios (HRs) for electrocardiogram markers. Subsequently, we evaluated if addition of these electrocardiogram markers to a clinical model improved risk prediction for non-AD using change in area under the receiver-operator characteristics curve (AUC).<bold>Results: </bold>The 5-year cumulative incidence of non-AD was 3.4 %. Increased heart rate (HR=1.06 pr. 10 bpm [95% confidence interval: 1.04-1.08], p<0.001), shorter QRS duration (HR=1.07 pr. 10 ms [1.05-1.09], p<0.001), elevated J-amplitude (HR=1.16 pr. mm [1.08-1.24], p<0.001), decreased T-peak amplitude (HR=1.02 pr. mm [1.01-1.04], p=0.002), and increased QTc (HR=1.08 pr. 20 ms [1.05-1.10], p<0.001) were associated with an increased rate of non-AD. Atrial fibrillation on the ECG (HR=1.18 [1.08-1.28], p<0.001) Sokolow-Lyon index > 35 mm (HR=1.31 [1.18-1.46], p<0.001) and borderline (HR=1.18 [1.11-1.26], p<0.001) or abnormal (HR=1.40 [1.27-1.55], p<0.001) QRS-T angle were also associated with an increased rate of non-AD. Upon addition of ECG markers to the Cox model, 5-year and 10-year C-statistic (AUC) improved significantly (delta-AUC, 0.36 [0.18-0.50] and 0.20 [0.03-0.35] %-points, respectively).<bold>Conclusions: </bold>ECG markers typical of an elevated cardiovascular risk profile were associated with non-AD and improved both 5-year and 10-year risk predictions for non-AD. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10523057
- Volume :
- 31
- Issue :
- 9
- Database :
- Supplemental Index
- Journal :
- Journal of Stroke & Cerebrovascular Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 158606928
- Full Text :
- https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106640