{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:07:13Z","timestamp":1791216433765,"version":"4.1.0"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:sec id=\"ab-ioi240037-4\"><jats:title>Importance<\/jats:title><jats:p>The resting electrocardiogram (ECG) is commonly performed for cardiovascular disease (CVD) screening purposes in Japan. However, evidence is limited regarding the prognostic significance of ECG in clinical practice settings.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240037-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate the association between ECG abnormalities and CVD outcomes in a working-age population.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240037-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This nationwide cohort study included individuals aged 35 to 65 years from the Japan Health Insurance Association database, which covers approximately 40% (30 million) of the working-age population in Japan. Data from April 1, 2015, to March 31, 2022, were included, and analysis was conducted from October 1, 2022, to April 11, 2024.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240037-7\"><jats:title>Exposures<\/jats:title><jats:p>Baseline ECG status (normal, 1 minor abnormality, \u22652 minor abnormalities, or major abnormality).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240037-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was a composite of overall death and CVD hospital admission due to myocardial infarction, stroke, or heart failure. The secondary outcome was developing a new major ECG abnormality over the years of screening.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240037-9\"><jats:title>Results<\/jats:title><jats:p>Of 3\u202f698\u202f429 individuals enrolled in the nationwide annual health check program (mean [SD] age, 47.1 [8.5] years; 66.6% male), 623\u202f073 (16.8%) had 1 minor ECG abnormality, 144\u202f535 (3.9%) had 2 or more minor ECG abnormalities, and 56\u202f921 (1.5%) had a major ECG abnormality. During a median follow-up of 5.5 (IQR, 3.4-5.7) years, baseline ECG abnormality was independently associated with an increased incidence of the composite end points of overall death and CVD admission compared with normal ECG (incidence rates per 10\u202f000 person-years: 92.7 [95% CI, 92.2-93.2] for normal ECG, 128.5 [95% CI, 127.2-129.9] for 1 minor ECG abnormality, 159.7 [95% CI, 156.6-162.9] for \u22652 minor ECG abnormalities, and 266.3 [95% CI, 259.9-272.3] for a major ECG abnormality; adjusted hazard ratios: 1.19 [95% CI, 1.18-1.20] for 1 minor ECG abnormality, 1.37 [95% CI, 1.34-1.39] for \u22652 minor ECG abnormalities, and 1.96 [95% CI, 1.92-2.02] for a major ECG abnormality). Furthermore, the presence and number of minor ECG abnormalities were associated with an increased incidence of developing new major ECG abnormalities (incidence rates per 10\u202f000 person-years: 85.1 [95% CI, 84.5-85.5] for normal ECG, 217.2 [95% CI, 215.5-219.0] for 1 minor ECG abnormality, and 306.4 [95% CI, 302.1-310.7] for \u22652 minor ECG abnormalities; and adjusted hazard ratios: 2.52 [95% CI, 2.49-2.55] for 1 minor ECG abnormality and 3.61 [95% CI, 3.55-3.67] for \u22652 minor ECG abnormalities). Associations were noted regardless of baseline CVD risk.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi240037-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>The findings of this study suggest that the potential role of routine ECG screening for early prevention of CVD events, along with the optimal follow-up strategy, should be examined in future studies.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamainternmed.2024.2270","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T15:01:21Z","timestamp":1719846081000},"page":"1035","source":"Crossref","is-referenced-by-count":57,"title":["Routine Electrocardiogram Screening and Cardiovascular Disease Events in Adults"],"prefix":"10.1001","volume":"184","author":[{"given":"Ryuichiro","family":"Yagi","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, 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