Electrocardiogram abnormalities and cardiovascular risk prediction in older Chinese: the Guangzhou Biobank Cohort Study
Authors' conclusion
Major EA and multiple minor EAs were associated with higher risks of CVD events and mortality, but the value in improving CVD risk prediction is limited.
Study context
- Population
- Chinese aged 50+ years from Guangzhou Biobank Cohort Study (GBCS), without cardiovascular disease (CVD) at baseline
- Participants
- 26,846 participants
- Exposure
- ECG abnormalities (EA) (severity/score) and incident CVD events, all-cause mortality and CVD mortality; improvement in CVD risk prediction after adding EA to the GBCS model variables
- Outcome
- Incident CVD events by EA severity
- Follow-up
- Average 15.3 (SD=3.5) years
Main finding
As reported in the abstract
Each group vs normal ECGAdjusted hazard ratio (95% CI)
One minor
1.12(1.05–1.19)
Two or more minor
1.20(1.11–1.29)
Major abnormalities
1.46(1.31–1.63)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Incident CVD events by EA score1-29 pointsvs 0 point | 1.12 (1.05–1.19) | |
| Incident CVD events by EA score30-59 pointsvs 0 point | 1.56 (1.38–1.77) | |
| Incident CVD events by EA score≥60 pointsvs 0 point | 3.16 (2.56–3.91) | |
| 0.20.5125Hazard ratio (log scale) |
- Incident CVD events by EA score: p value for trend <0.001
All-cause and CVD mortality
- Similar findings were observed for all-cause and CVD mortality
Events during follow-up · average follow-up of 15.3 (SD=3.5) years
- CVD events
- 6232
- Deaths
- 5960
Change in C-index after adding EA score (incident CVD events)
- At 3 years
- 0.011 (95% CI 0.002 to 0.022)
- At 15 years
- 0.003 (95% CI 0.002 to 0.004)
- The improvement diminished over time
Net Reclassification Index (NRI) for 10-year risk
- NRI
- 0.016 (95% CI 0.007 to 0.024)
- Indicating limited utility
Original publication
Electrocardiogram abnormalities and cardiovascular risk prediction in older Chinese: the Guangzhou Biobank Cohort Study. Heart. Published 27 August 2025. doi:10.
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