{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:44:46Z","timestamp":1786977886172,"version":"build-2736575974"},"reference-count":55,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Cardiovascular disease remains a leading cause of morbidity and mortality worldwide, making early detection and risk assessment critical. Various clinical tools, including the Atherosclerotic Cardiovascular Disease (ASCVD) risk score, have been developed to predict cardiovascular risk. This study aimed to evaluate the association of various Electrocardiogram (ECG) findings with 10\u2010year ASCVD risk scores in asymptomatic individuals without prior cardiovascular events, using data from the Shiraz Heart Study (SHS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional study included participants aged 40\u201370 years from the Shiraz Heart Study (SHS). Inclusion criteria required complete ECG data and recorded ASCVD risk factors. ECG findings, encompassing both continuous and categorical variables, were reviewed by trained cardiologists. ASCVD risk scores were calculated using demographic and clinical variables. Statistical analyses, including multivariate regression, assessed associations between ECG parameters and 10\u2010year ASCVD risk scores, adjusting for key confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      A total of 1471 participants were included in the study, with 44.5% male (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009654) and a mean age of 51.65 years (SD\u2009=\u20097.84). The mean ASCVD score was 5.49 (SD\u2009=\u20096.41). Significant associations were found between continuous ECG variables, such as P\u2010wave duration, PR interval, QRS duration, and QRS axis, with ASCVD risk. Categorical ECG findings, including ST depression, ST elevation, left bundle branch block (LBBB), prolonged P\u2010wave duration, and left atrial enlargement, were also significantly associated with ASCVD scores. Multivariate linear regression identified ST depression (\n                      <jats:italic>B<\/jats:italic>\n                      \u2009=\u20090.060,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and LBBB (\n                      <jats:italic>B<\/jats:italic>\n                      \u2009=\u20090.031,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039) as independent predictors of ASCVD risk, after adjusting for confounders such as age, gender, hypertension, diabetes, and cholesterol levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ST depression and LBBB show a modest association with cardiovascular risk stratification using the 10\u2010year ASCVD risk score. Incorporating these ECG markers into clinical assessments may aid in identifying high\u2010risk individuals, enabling more personalized interventions and refining cardiovascular risk prediction models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71026","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T05:54:56Z","timestamp":1752126896000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association Between ECG Findings and Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score: A Cross\u2010Sectional Analysis of a Cohort Study"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8563-6005","authenticated-orcid":false,"given":"Pouria","family":"Azami","sequence":"first","affiliation":[{"name":"School of Medicine Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Department of Cardiovascular Medicine, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Cardiovascular Research Center, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3920-8640","authenticated-orcid":false,"given":"Alireza","family":"Mirhosseini","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"},{"name":"MD\u2010MPH Department, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadjavad","family":"Nobakhti","sequence":"additional","affiliation":[{"name":"School of Medicine Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Department of Cardiovascular Medicine, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrab","family":"Sayadi","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Keshavarz","sequence":"additional","affiliation":[{"name":"School of Medicine Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Department of Cardiovascular Medicine, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masood Dindari","family":"Parizi","sequence":"additional","affiliation":[{"name":"School of Medicine Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Department of Cardiovascular Medicine, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raziye","family":"Saeedizade","sequence":"additional","affiliation":[{"name":"School of Medicine Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Department of Cardiovascular Medicine, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4060-5593","authenticated-orcid":false,"given":"Mahsa","family":"Borjzadeh","sequence":"additional","affiliation":[{"name":"School of Medicine Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Department of Cardiovascular Medicine, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Javad","family":"Zibaeenezhad","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Cardiovascular Research Center, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4133-4870","authenticated-orcid":false,"given":"Armin","family":"Attar","sequence":"additional","affiliation":[{"name":"School of Medicine Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Department of Cardiovascular Medicine, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.10.009"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.11.005"},{"key":"e_1_2_12_4_1","volume-title":"National Institute for Health and Clinical Excellence: Guidance. A Systematic Review of Risk Scoring Methods and Clinical Decision Aids Used in the Primary Prevention of Coronary Heart Disease (Supplement)","author":"Beswick A. D.","year":"2008"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-55-1-33"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-668X(03)00114-3"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab312"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.022367"},{"issue":"25","key":"e_1_2_12_9_1","first-page":"S49","article-title":"2013 ACC\/AHA Guideline on the Assessment of Cardiovascular Risk","volume":"129","author":"Goff D. C.","year":"2014","journal-title":"Circulation"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000677"},{"issue":"6","key":"e_1_2_12_11_1","first-page":"13","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"71","author":"Whelton P. K.","year":"2018","journal-title":"Hypertension"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S337466"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.2173"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.03.020"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2010.03.005"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu081"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026317"},{"key":"e_1_2_12_18_1","unstructured":"LITFL. ECG Library (n.d.) https:\/\/litfl.com\/ecg-library\/."},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.10.009"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.07.018"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-022-02601-0"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacasi.2025.01.006"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacasi.2021.04.007"},{"issue":"3","key":"e_1_2_12_24_1","first-page":"138","article-title":"Incidence of Cardiovascular Diseases in an Iranian Population: The Isfahan Cohort Study","volume":"16","author":"Talaei M.","year":"2013","journal-title":"Archives of Iranian Medicine"},{"issue":"4","key":"e_1_2_12_25_1","first-page":"204","article-title":"Cardiovascular Disease in Iran in the Last 40 Years: Prevalence, Mortality, Morbidity, Challenges and Strategies for Cardiovascular Prevention","volume":"22","author":"Sarrafzadegan N.","year":"2019","journal-title":"Archives of Iranian Medicine"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJR.0b013e328322ca1b"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2020.100594"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.15420\/ecr.2021.36"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy462"},{"key":"e_1_2_12_30_1","volume-title":"ST Segment. StatPearls","author":"Kashou A. H.","year":"2023"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2003.09.001"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2020.09.011"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz425"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartjsupp\/suae036.444"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi395"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn584"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000549"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.01.084"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20034"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.119.008239"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.342.14103"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-021-01628-7"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2016.07.002"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi008"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31826e1058"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.5334\/gh.790"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2012.10.030"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.08.028"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00128-2"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/anec.12196"},{"key":"e_1_2_12_51_1","unstructured":"D.ScherbakandG. J.Hicks Left Bundle Branch Block(StatPearls Publishing 2018)."},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.121.007908"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpc.2022.100335"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-068948"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.976769"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102259"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.71026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T05:13:58Z","timestamp":1764479638000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.71026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":55,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/hsr2.71026"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.71026","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71026"}}