Screening for cardiovascular disease risk with electrocardiography us preventive services task force recommendation statement

US Preventive Services Task Force

Research output: Contribution to journalArticle

18 Citations (Scopus)

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).

Original languageEnglish (US)
Pages (from-to)2308-2314
Number of pages7
JournalJAMA - Journal of the American Medical Association
Volume319
Issue number22
DOIs
StatePublished - Jun 12 2018

Fingerprint

Advisory Committees
Electrocardiography
Cardiovascular Diseases
Exercise
Coronary Disease
Cerebrovascular Disorders
Peripheral Arterial Disease
Health
Risk Management
Cause of Death

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Screening for cardiovascular disease risk with electrocardiography us preventive services task force recommendation statement. / US Preventive Services Task Force.

In: JAMA - Journal of the American Medical Association, Vol. 319, No. 22, 12.06.2018, p. 2308-2314.

Research output: Contribution to journalArticle

@article{0ee53eb3b8684f1695c5b9f2f99ee8d9,
title = "Screening for cardiovascular disease risk with electrocardiography us preventive services task force recommendation statement",
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).",
author = "{US Preventive Services Task Force} and Curry, {Susan J.} and Krist, {Alex H.} and Owens, {Douglas K.} and Barry, {Michael J.} and Aaron Caughey and Davidson, {Karina W.} and Doubeni, {Chyke A.} and Epling, {John W.} and Kemper, {Alex R.} and Martha Kubik and {Seth Landefeld}, C. and Mangione, {Carol M.} and Michael Silverstein and Simon, {Melissa A.} and Tseng, {Chien Wen} and Wong, {John B.}",
year = "2018",
month = "6",
day = "12",
doi = "10.1001/jama.2018.6848",
language = "English (US)",
volume = "319",
pages = "2308--2314",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "22",

}

TY - JOUR

T1 - Screening for cardiovascular disease risk with electrocardiography us preventive services task force recommendation statement

AU - US Preventive Services Task Force

AU - Curry, Susan J.

AU - Krist, Alex H.

AU - Owens, Douglas K.

AU - Barry, Michael J.

AU - Caughey, Aaron

AU - Davidson, Karina W.

AU - Doubeni, Chyke A.

AU - Epling, John W.

AU - Kemper, Alex R.

AU - Kubik, Martha

AU - Seth Landefeld, C.

AU - Mangione, Carol M.

AU - Silverstein, Michael

AU - Simon, Melissa A.

AU - Tseng, Chien Wen

AU - Wong, John B.

PY - 2018/6/12

Y1 - 2018/6/12

N2 - 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).

AB - 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).

UR - http://www.scopus.com/inward/record.url?scp=85048522138&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048522138&partnerID=8YFLogxK

U2 - 10.1001/jama.2018.6848

DO - 10.1001/jama.2018.6848

M3 - Article

C2 - 29896632

AN - SCOPUS:85048522138

VL - 319

SP - 2308

EP - 2314

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 22

ER -