Please use this identifier to cite or link to this item: https://doi.org/10.1161/JAHA.115.002956
Title: Racial differences in electrocardiographic characteristics and prognostic significance in Whites versus Asians
Authors: Santhanakrishnan, R
Wang, N
Larson, M.G
Magnani, J.M
Vasan, R.S
Wang, T.J
Yap, J
Feng, L 
Yap, K.B 
Ong, H.Y
Ng, T.P 
Richards, A.M 
Lam, C.S.P 
Ho, J.E
Keywords: aged
Article
Asian
cardiovascular risk
Caucasian
controlled study
electrocardiography
female
follow up
human
male
mortality rate
PR interval
priority journal
prognosis
QT interval
race difference
action potential
Asian continental ancestry group
Cardiovascular Diseases
Caucasian
clinical trial
comparative study
epidemiology
ethnology
health disparity
heart muscle conduction system
heart rate
Hypertrophy, Left Ventricular
Kaplan Meier method
longitudinal study
Massachusetts
middle aged
mortality
multicenter study
multivariate analysis
pathophysiology
predictive value
prognosis
proportional hazards model
prospective study
risk assessment
risk factor
sex difference
Singapore
statistical model
time factor
very elderly
Action Potentials
Aged
Aged, 80 and over
Asian Continental Ancestry Group
Cardiovascular Diseases
Electrocardiography
European Continental Ancestry Group
Female
Health Status Disparities
Heart Conduction System
Heart Rate
Humans
Hypertrophy, Left Ventricular
Kaplan-Meier Estimate
Linear Models
Longitudinal Studies
Male
Massachusetts
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Assessment
Risk Factors
Sex Factors
Singapore
Time Factors
Issue Date: 2015
Citation: Santhanakrishnan, R, Wang, N, Larson, M.G, Magnani, J.M, Vasan, R.S, Wang, T.J, Yap, J, Feng, L, Yap, K.B, Ong, H.Y, Ng, T.P, Richards, A.M, Lam, C.S.P, Ho, J.E (2015). Racial differences in electrocardiographic characteristics and prognostic significance in Whites versus Asians. Journal of the American Heart Association 5 (3) : e002956. ScholarBank@NUS Repository. https://doi.org/10.1161/JAHA.115.002956
Abstract: Background: Racial differences in electrocardiographic (ECG) characteristics and prognostic significance among Whites and Asians are not well described. Methods and Results: We studied 2677 White Framingham Heart Study participants (57% women) and 2972 Asian (64% women) Singapore Longitudinal Aging Study participants (mean age 66 years in both) free of myocardial infarction or heart failure. Racial differences in ECG characteristics and effect on mortality were assessed. In linear regression models, PR interval was longer in Asians compared with Whites (multivariable-adjusted β±SE 5.0±1.4 ms in men and 6.6±0.9 ms in women, both P<0.0006). QT interval was shorter in Asian men (β±SE -6.2±1.2 ms, P<0.0001) and longer in Asian women (β±SE 3.6±0.9 ms, P=0.02) compared to White men and women, respectively. Asians had greater odds of having ECG left ventricular hypertrophy (LVH) compared with Whites (odds ratio [OR] 3.56, 95% confidence interval [CI] 1.36-9.35 for men, OR 1.93, 95% CI 1.35-2.76 for women, both P<0.02). Over a mean follow-up of 11±3 years in Framingham and 8±3 years in Singapore, mortality rates were 24.5 and 13.4 per 1000 person-years among Whites and Asians, respectively. In Cox models, the presence of LVH had a greater effect on all-cause mortality in Asians compared with Whites (hazard ratio [HR] 2.66, 95% CI 1.83-3.88 vs HR 1.30, 95% CI 0.90-1.89, P for interaction=0.02). Conclusion: Our findings from two large community-based cohorts show prominent race differences in ECG characteristics between Whites and Asians, and also suggest a differential association with mortality. These differences may carry implications for race-specific ECG reference ranges and cardiovascular risk. © 2016 The Authors.
Source Title: Journal of the American Heart Association
URI: https://scholarbank.nus.edu.sg/handle/10635/176003
ISSN: 2047-9980
DOI: 10.1161/JAHA.115.002956
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