Abnormal Exercise Electrocardiography With Normal Stress Echocardiography Is Associated With Subclinical Coronary Atherosclerosis
Authors' conclusion
Individuals with a +ECG/-Echo have a higher burden of subclinical coronary atherosclerosis than those with a -ECG/-Echo, which may explain, at least in part, the increased risk for adverse cardiac events in this population. Further study is needed to determine the optimal strategy for mitigating cardiovascular risk in these patients.
Study context
- Population
- Asymptomatic Project Baseline Health Study participants who underwent a stress Echo and coronary artery calcium (CAC) scan
- Participants
- 1,630 asymptomatic participants
- Exposure
- +ECG/-Echo vs -ECG/-Echo
- +ECG/-Echon = 105
- -ECG/-Echon = 1,503reference
- +Echon = 22
- Outcome
- Mean CAC score
Main finding
As reported in the abstract
+ECG/-Echo
198
mean · SD 470
-ECG/-Echo
53
mean · SD 186
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted odds ratio (95% CI) | P value | |
|---|---|---|---|
| CAC score ≥400+ECG/-Echovs -ECG/-Echo | 4.54 (1.95–10.05) | P < 0.001 | |
| 0.050.21520Adjusted odds ratio (log scale) |
| Outcome | +ECG/-Echo | -ECG/-Echo | Relative difference | P value |
|---|---|---|---|---|
| CAC log+ECG/-Echo vs -ECG/-Echo · mean | 2.2 (SD 2.7) | 1.2 (SD 2.0) | P < 0.001 | |
| CAC=0-ECG/-Echo vs +ECG/-Echo | 53.3% | 65.9% | P = 0.01 | |
| CAC ≥100+ECG/-Echo vs -ECG/-Echo | 28.6% | 11.4% | P < 0.001 | |
| Adjusted CAC log scores+ECG/-Echo vs -ECG/-Echo · higher in the +ECG/-Echo group · After adjustment | 52% | P = 0.002 |
Composite of adverse cardiovascular events · median follow-up of 4.3 years
- A trend toward increased adverse cardiovascular events was observed among participants with +ECG/-Echo
Original publication
Abnormal Exercise Electrocardiography With Normal Stress Echocardiography Is Associated With Subclinical Coronary Atherosclerosis. Circ Cardiovasc Imaging. Published 13 January 2025. doi:10.
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