Longitudinal association of electrocardiogram abnormalities with major adverse cardiac events in people with Type 2 diabetes: the Hoorn Diabetes Care System cohort
Authors' conclusion
In people with T2D without pre-existing CVD, ECG abnormalities related to decelerated conduction, ischaemia, and hypertrophy are predominantly early signs of emerging HF, while only abnormalities related to ischaemic disorders are signs of CHD.
Study context
- Population
- People with T2DM without known cardiovascular disease (CVD), Hoorn Diabetes Care System cohort, 1998–2018905 (7.5%) had major adverse cardiac events (MACE)
- Participants
- 11,993 people
- Exposure
- Electrocardiogram (ECG) abnormalities vs none
- Outcome
- Incident MACE:
- CHD
- HF
- Sudden cardiac arrest
- Follow-up
- Median 6.6 (IQR, 3.1-10.7) years
Methodological detailslongitudinal, time-dependent Cox regression, annually repeated measurements
- Longitudinal
- Time-dependent Cox regression
- Annually repeated measurements
Main finding
As reported in the abstract
Incident MACE by type (adjusted)
Hazard ratio (95% CI)
Prolonged QRS durationHF
4.01(2.67–6.03)
QS patternHF
2.68(0.85–8.49)
ST-segment/T-wave abnormalitiesHF
4.26(2.67–6.80)
Tall R-waveHF
2.23(1.33–3.76)
QS patternCHD
2.69(1.20–6.03)
ST-segment/T-wave abnormalitiesCHD
2.11(1.48–3.02)
- MACE: 529 coronary heart disease (CHD), 250 heart failure (HF), 126 sudden cardiac arrest (SCA)
- 905 (7.5%)
Observational data: associations, not effects.
Further findings
Any ECG abnormality (prevalent or incident)
- Participants with an ECG abnormality
- 5445 (45.4%)
- Median 6 (IQR, 3-10) annual ECG recordings
Subgroups by age, sex, hypertension, estimated CVD risk
- Associations robust across subgroups
Original publication
Longitudinal association of electrocardiogram abnormalities with major adverse cardiac events in people with Type 2 diabetes: the Hoorn Diabetes Care System cohort. Eur J Prev Cardiol. Published 10 January 2023. doi:10.
Summarised from the published abstract; every number is checked against it