Assessment of electrocardiogram abnormality and associated factors among apparently healthy adult type 2 diabetic patients on follow-up at Jimma Medical Center, Southwest Ethiopia: Cross-sectional study

Background Diabetes mellitus is a group of metabolic disorders causing long-term damage to the cardiovascular system which remains asymptomatic among diabetic patients. An electrocardiograph is a simple and first-line tool in the screening of cardiovascular diseases. Objective To assess electrocardiogram abnormality and associated factors among apparently healthy adult type 2 diabetes patients on follow-up at Jimma Medical Center, 2019. Materials and methods Institutional based cross-sectional study was conducted from April 1 to May 30, 2019, at Jimma Medical Center among selected type 2 diabetes patients. Systematic random sampling was employed to select the study participants. The World Health Organization stepwise approach and interviewer-administered semi-structured questionnaires were employed to collect basic data. Resting Electrocardiography was done using a standard 12-lead electrocardiograph machine. The collected data were checked for completeness, coded, entered into the Epi-data Version 4.0.2. and exported to SPSS Version 21. Descriptive statistics like frequencies, percentages, mean and standard deviations were carried out. Binary and multiple logistic regression was done and a p value of less than 0.05 was used as a level of significance. Results A total of 344 type 2 diabetes patients were interviewed and underwent electrocardiography making a 100% response rate. Electrocardiographic abnormality was identified among 209 (61%) of the respondents. Not attending formal education [AOR = 3.07, 95%, CI = 1.37–6.87], solid oil use, [AOR = 1.79, 95%, CI = 1.07–2.98], body mass index ≥ 25 kg/m2 [AOR = 2.74, 95%, CI = 1.67–4.50] and long duration of diabetes ≥ 10 years [AOR = 3.36, 95%, CI = 1.46–7.71] were associated with electrocardiogram abnormality. Conclusions and recommendation In this study, the majority (3/5th) of the participant had electrocardiogram abnormality. Not attending formal education, longer duration of diabetes ≥ 10 years, solid oil use, and increased body mass index ≥ 25 kg/m2 were independent predictors of electrocardiographic abnormality. Integrating electrocardiogram screening in routine diabetic management can pick cardiac complications of diabetes.

Prognostic value of electrocardiographic abnormalities in adults from the Brazilian longitudinal study of adults’ health

ObjectiveCardiovascular diseases (CVDs) are highly preventable non-communicable diseases. ECG is a potential tool for risk stratification with respect to CVD. Our aim was to evaluate ECG’s role in all-cause and cardiovascular mortality prediction.MethodsParticipants from the Brazilian Longitudinal Study of Adult Health, free of known CVD at baseline were included. A 12-lead ECG was obtained at baseline (2008–2010). Participants were followed up to 2018 by annual interviews. Deaths were independently reviewed. Cox as well as Fine and Grey multivariable regression models were applied to evaluate if the presence of any major electrocardiographic abnormality (MEA), defined according to the Minnesota Code system, would predict total and cardiovascular deaths. We also evaluated the Net Reclassification Index of adding MEA to the Systematic Coronary Risk Evaluation (SCORE).ResultsThe 13 428 participants (median age 51 years, 45% men) were followed up for 8±1 years. All-cause and cardiovascular mortality occurred in 2.8% and 1.2% of the population, respectively. Prevalent MEA was an independent predictor of overall (HR=2.3, 95% CI 1.7 to 2.9) and cardiovascular mortality (HR=4.6, 95% CI 3.0 to 7.0) after adjustments for age, race, education and traditional cardiovascular risk factors. Adding MEA to the SCORE resulted in 9% mis-reclassification in the non-event subgroup and 33% correct reclassification in those with a fatal cardiovascular event.ConclusionPresence of MEA was an independent predictor of overall and cardiovascular mortality. ECG may have a role in risk prediction of cardiovascular mortality in primary care.

Abstract 13619: Major Electrocardiographic Abnormalities in Brazilian Adults: Prognostic Value and Potential Use in Primary Prevention (from the Elsa-Brasil Cohort Study)

Introduction: Cardiovascular diseases (CVD) are the most preventable noncommunicable diseases. Accurate risk stratification is paramount for identifying patients for whom interventions should be offered. The electrocardiogram (ECG) is a potential tool for CVD primary prevention. Our aim is to evaluate the ECG role as an independent predictor of all-cause and cardiovascular mortality Methods: Participants from the Longitudinal Study of Adult Health (ELSA-Brasil), who were free of known CVD at baseline were included. A 12-lead ECG was obtained at baseline (2008-2010).Participants were followed up to 2018 by annual interviews.Deaths and hospitalizations were independently reviewed. Cox and Fine and Gray competitive risk regressions were applied to evaluate if the presence of any major electrocardiographic abnormality (MEA) at baseline, defined according to de Minnesota Code system (MC), would predict total and cardiovascular deaths in multivariable models Results: The 13,437 participants (mean age 51.8 years, 55% women) were followed for 8±1 years. Baseline prevalence of MEA was 7.2% for men, 5.8% for women. All-cause and cardiovascular mortality occurred in 5.7% and 1.2% of men, and 3.1% and 1.2% of women, respectively. Prevalent MEA was an independent predictor of overall mortality after adjustments for age, race, education and traditional cardiovascular risk factors (HR:2.2; 95%CI 1.6-2.9 for men and HR:2.3; 95%CI 1.6-3.4 for women). [LB1] In the competitive risk model for cardiovascular death, the increased risk attributable to MEA was even higher (HR4.1, 95%CI 2.47-6.81 in men and 5.37, 95%CI 2.54-11.36 in women). Conclusions: Presence of MEA was a strong and independent predictor of overall and cardiovascular death for both sexes. ECG may have a role in improving risk assessment for death in primary care