Journal article
Screening for Cardiovascular Disease Risk With Electrocardiography US Preventive Services Task Force Recommendation Statement
JAMA : the journal of the American Medical Association, Vol.319(22), pp.2308-2314
06/12/2018
DOI: 10.1001/jama.2018.6848
PMID: 29896632
Abstract
IMPORTANCE Cardiovascular disease (CVD), which encompasses atherosclerotic conditions such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease, is the most common cause of death among adults in the United States. Treatment to prevent CVD events by modifying risk factors is currently informed by CVD risk assessment with tools such as the Framingham Risk Score or the Pooled Cohort Equations, which stratify individual risk to inform treatment decisions.
OBJECTIVE To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on screening for coronary heart disease with electrocardiography (ECG).
EVIDENCE REVIEW The USPSTF reviewed the evidence on whether screening with resting or exercise ECG improves health outcomes compared with the use of traditional CVD risk assessment alone in asymptomatic adults.
FINDINGS For asymptomatic adults at low risk of CVD events (individuals with a 10-year CVD event risk less than 10%), it is very unlikely that the information from resting or exercise ECG (beyond that obtained with conventional CVD risk factors) will result in a change in the patient's risk category as assessed by the Framingham Risk Score or Pooled Cohort Equations that would lead to a change in treatment and ultimately improve health outcomes. Possible harms are associated with screening with resting or exercise ECG, specifically the potential adverse effects of subsequent invasive testing. For asymptomatic adults at intermediate or high risk of CVD events, there is insufficient evidence to determine the extent to which information from resting or exercise ECG adds to current CVD risk assessment models and whether information from the ECG results in a change in risk management and ultimately reduces CVD events. As with low-risk adults, possible harms are associated with screening with resting or exercise ECG in asymptomatic adults at intermediate or high risk of CVD events.
CONCLUSIONS AND RECOMMENDATION The USPSTF recommends against screening with resting or exercise ECG to prevent CVD events in asymptomatic adults at low risk of CVD events. (D recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening with resting or exercise ECG to prevent CVD events in asymptomatic adults at intermediate or high risk of CVD events. (I statement)
Details
- Title: Subtitle
- Screening for Cardiovascular Disease Risk With Electrocardiography US Preventive Services Task Force Recommendation Statement
- Creators
- Susan J. Curry - University of IowaAlex H. Krist - Virginia Commonwealth UniversityDouglas K. Owens - Stanford UniversityMichael J. Barry - Harvard UniversityAaron B. Caughey - Oregon Health & Science UniversityKarinaW Davidson - Columbia UniversityChyke A. Doubeni - Univ Penn, Philadelphia, PA 19104 USAJohn W. Epling - Virginia TechAlex R. Kemper - Nationwide Children's HospitalMartha Kubik - Temple UniversityC. Seth Landefeld - University of Alabama at BirminghamCarol M. Mangione - University of California, Los AngelesMichael Silverstein - Boston UniversityMelissa A. Simon - Northwestern UniversityChien-Wen Tseng - Honolulu UniversityJohn B. Wong - Tufts UniversityUS Preventive Services Task Force
- Resource Type
- Journal article
- Publication Details
- JAMA : the journal of the American Medical Association, Vol.319(22), pp.2308-2314
- Publisher
- Amer Medical Assoc
- DOI
- 10.1001/jama.2018.6848
- PMID
- 29896632
- ISSN
- 0098-7484
- eISSN
- 1538-3598
- Number of pages
- 7
- Language
- English
- Date published
- 06/12/2018
- Academic Unit
- Health Management and Policy; Community and Behavioral Health
- Record Identifier
- 9984366368702771
Metrics
6 Record Views