ArticleEuropean heart journal2017
Electrical risk score beyond the left ventricular ejection fraction: prediction of sudden cardiac death in the Oregon Sudden Unexpected Death Study and the Atherosclerosis Risk in Communities Study.
Article in European heart journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 2 of them syntheses that pooled it.
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Who cites it
76 citing papers in PubMed, 2 syntheses or guidelines pooled it, 146 citations in OpenAlex.
- Risk Prediction for Sudden Cardiac Death in the General Population: A Systematic Review and Meta-Analysis.International journal of public health · 2024Pooled it
- Body mass index, abdominal fatness, and the risk of sudden cardiac death: a systematic review and dose-response meta-analysis of prospective studies.European journal of epidemiology · 2018Pooled it
- Effect of Intensive Glycemic and Blood Pressure Control on QT Prolongation in Diabetes: The ACCORD Trial.Diabetes · 2020Trial
- Predictive Value of the Electrical Risk Score for Ventricular Arrhythmias in Heart Failure Patients with Primary Prevention Implantable Cardioverter Defibrillators.Journal of clinical medicine · 2026Article
- A Cumulative Electrical Risk Score Is Associated with Appropriate ICD Therapy in Primary-Prevention Patients with Reduced Ejection Fraction: A Single-Center Retrospective Study.Journal of clinical medicine · 2026Article
- Article
- Artificial Intelligence-Enabled Electrocardiography for Prediction of Sudden Cardiac Death and Malignant Ventricular Arrhythmias: A Scoping Review.Journal of cardiovascular development and disease · 2026Review
- Electrical risk score and electrocardiographic markers in acute cholecystitis: a prospective cross-sectional study using explainable machine learning.BMC cardiovascular disorders · 2026Article
- Development and temporal validation of a two-stage ECG-based machine learning model for LVEF screening: a Middle Eastern cohort study.BMC cardiovascular disorders · 2026Article
- Electrical risk score as a predictor of acute ischemic stroke and 30-day mortality: a prospective observational study.BMC neurology · 2026Observational
- Performance of the 12-lead ECG in predicting short- and long-term risk of sudden cardiac death.NPJ digital medicine · 2026Article
- Electrocardiographic predictors of ventricular arrhythmic events in ICD recipients: signal beyond the left ventricular ejection fraction threshold.BMC cardiovascular disorders · 2026Article
- Holter Monitor QT Dispersion and QTc-Dispersion in Pediatric Long QT Syndrome and Development of a Diagnostic and Arrhythmia Risk Prediction Model.Journal of the American Heart Association · 2025Article
- Anticholinergic medications and out-of-hospital sudden cardiac arrest: a new piece to the puzzle?European heart journal · 2025Article
- Prevalence, associated factors, and prognostic value of P wave abnormality in patients with coronary artery disease.International journal of cardiology. Cardiovascular risk and prevention · 2025Article
- Electrical Risk Score as a Predictor of Coronary Artery Disease.Journal of clinical medicine · 2025Article
- Markers of sudden cardiac death associated with the ventricular-paced 12-lead ECG.European heart journal open · 2025Article
- Machine learning for sudden cardiac death prediction among older adults using community-based electronic health records.BMC public health · 2025Article
- A Cardiac Magnetic Resonance-Based Risk Stratification for Life-Threatening Ventricular Tachyarrhythmias in Heart Failure: The SNENMR in biomedicine · 2025Article
- Age-Specific Mechanisms of Sudden Death Associated With Epilepsy.JACC. Clinical electrophysiology · 2025Article
16 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
aimsThere is an urgent need to extend sudden cardiac death (SCD) risk stratification beyond the left ventricular ejection fraction (LVEF). We evaluated whether a cumulative electrocardiogram (ECG) risk score would improve identification of individuals at high risk of SCD. METHODS AND
resultsIn the community-based Oregon Sudden Unexpected Death Study (catchment population ∼1 million), 522 SCD cases with archived 12-lead ECG available (65.3 ± 14.5 years, 66% male) were compared with 736 geographical controls to assess the incremental value of multiple ECG parameters in SCD prediction. Heart rate, LV hypertrophy, QRS transition zone, QRS-T angle, QTc, and Tpeak-to-Tend interval remained significant in the final model, which was externally validated in the Atherosclerosis Risk in Communities (ARIC) Study. Sixteen percent of cases and 3% of controls had ≥4 abnormal ECG markers. After adjusting for clinical factors and LVEF, increasing ECG risk score was associated with progressively greater odds of SCD. Overall, subjects with ≥4 ECG abnormalities had an odds ratio (OR) of 21.2 for SCD [95% confidence interval (CI) 9.4-47.7; P < 0.001]. In the LVEF >35% subgroup, the OR was 26.1 (95% CI 9.9-68.5; P < 0.001). The ECG risk score increased the C-statistic from 0.625 to 0.753 (P < 0.001), with net reclassification improvement of 0.319 (P < 0.001). In the ARIC cohort validation, risk of SCD associated with ≥4 ECG abnormalities remained significant after multivariable adjustment (hazard ratio 4.84; 95% CI 2.34-9.99; P < 0.001; C-statistic improvement 0.759-0.774; P = 0.019).
conclusionThis novel cumulative ECG risk score was independently associated with SCD and was particularly effective for LVEF >35% where risk stratification is currently unavailable. These findings warrant further evaluation in prospective clinical investigations.
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