Abstract P415: Correlation of Screening Electrocardiogram, Transthoracic Echocardiogram, and ASCVD Risk Score to 10 Year ASCVD Outcomes Among Asymptomatic Community Dwelling Women

Abstract

Background: The efficacy and value of non-traditional screening methods such as electrocardiogram (ECG) and transthoracic echocardiography(TTE) remain unknown. In this study, we examined the correlation between initial ECG and TTE findings, and atherosclerotic cardiovascular disease (ASCVD) 10 year risk score with actual 10-year ASCVD outcomes among asymptomatic women from a community-based screening program cohort at Rush University Medical Center. Methodology: A 10-year follow-up survey was conducted in March-September 2018 from the 355 participants from the initial 2BigHearts community screening program in 2007. Demographics, past medical history, ASCVD outcomes (stroke, non-fatal MI, PAD), and self-reported medication lists were obtained from the 107 participants who responded to the survey. Pearson Chi-square Test was used to determine the association of ECG, TTE, and calculated ASCVD risk score with ASCVD outcomes and heart failure(HF). Results: Amongst the 107 participants (mean age 63±10.6 years, 68.3% (71/104) Caucasian, 18.3% (19/104) African American, 8.6% (9/104) Hispanic, 4.8% (5/104) Asian), 15% (16/107) had baseline TTE abnormality with chamber enlargement as most common while 29.9% (32/107) had baseline ECG abnormality with conduction abnormalities as most common. The mean ASCVD 10 year risk score was 4.02%±4.5%. Of the 107, 11 had ASCVD score ≥ 7.5% of which 2 developed non-fatal MI and PAD. Other co-morbid conditions included 29% (31/107) hyperlipidemia, 22.4% (24/107) hypertension, 8.4% (9/107) diabetes, 6.5% (7/107) obstructive sleep apnea and 12.1% (13/107) any type of cancer. Chi-square testing showed no statistically significant correlation between ECG or TTE abnormality with ASCVD outcome (p=0.251 ECG, p=0.461 TTE). Baseline ASCVD risk score of ≥7.5% was associated with 10-year ASCVD outcome (p=0.003) and abnormal TTE at baseline was associated with heart failure in 10-year follow-up (p=0.017). Conclusion: This study found no association between abnormal screening ECG and TTE findings with 10-year ASCVD outcomes (stroke, non-fatal MI, PAD). However, abnormal TTE findings are associated with HF. ASCVD pooled cohort equation proved to be better than ECG and TTE in predicting ASCVD outcomes.