Washington, D. C., USA: “Task Force recommends against ECG screening in adults at low risk for CVD and finds insufficient evidence on ECG screening in those at medium or high risk”, the U.S. Preventive Services Task Force (Task Force) said today as it posted a final recommendation statement and evidence summary on screening for cardiovascular disease (CVD) risk with electrocardiography (ECG).
The Task Force said it reviewed evidence on whether adding ECG, a test that records the activity of a person’s heart, to the standard ways of measuring CVD risk can improve risk assessment and help prevent heart attack or stroke in people without signs or symptoms of CVD. Based on the evidence.
The Task Force recommends against adding ECG screening to standard risk assessments in people at low risk.
Assessing CVD risk is traditionally based on factors such as age, race/ethnicity, sex, obesity, diabetes,smoking status, cholesterol levels, and blood pressure. “Adding ECG screening for people at low risk of a heart attack or stroke is unlikely to help prevent CVD events and can actually cause harms from subsequent procedures such as angiograms,” says Task Force member Seth Landefeld, M.D. “Anyone who has questions about their risk for heart disease, heart attack, or stroke should talk to their clinician.”
The Task Force also found that there is insufficient evidence to recommend for or against adding ECG screening to standard risk assessment methods in adults at medium or high risk of heart attack or stroke. This means that the balance of benefits and harms cannot be determined.
“There is not enough evidence for those who might benefit the most—people at higher risk for CVD—to say if adding ECG screening helps prevent heart attack and stroke,” says Task Force member Michael J. Barry, M.D. “Clinicians should continue to use traditional risk factors to assess CVD risk and guide treatment for these patients until more evidence is available.”
The U.S. Preventive Services Task Force (USPSTF or Task Force) is an independent panel of non-Federal experts that makes recommendations on clinical preventive services, such as screenings, counseling, and preventive medications, to primary care clinicians. USPSTF recommendations apply to people with no signs or symptoms of the disease, and are based on a rigorous, systematic review of peer-reviewed evidence.
Task Force members are primary care providers (such as internists, pediatricians, family physicians, nurses, gynecologists/obstetricians, and health behavior specialists) who are experts in prevention and evidence-based medicine. Members are required to disclose any possible conflicts of interest for each topic under review.
Dr. Landefeld is the chair of the department of medicine and the Spencer chair in medical science leadership at the University of Alabama at Birmingham (UAB) School of Medicine. Dr. Landefeld also serves on the board of directors of the American Board of Internal Medicine, the UAB Health System, and the University of Alabama Health Services Foundation.
The recommendation against routine ECGs in low-risk patients was published Tuesday in JAMA, the Journal of the American Medical Association.
Other doctors welcomed the new recommendations, noting they are consistent with those of many other medical groups. “I think their recommendations are very reasonable,” says Robert Hendel, chief of cardiology at Tulane University, speaking on behalf of the American College of Cardiology.
Hendel and others hope the uniformity of the recommendations will finally persuade more doctors to stop using the test so commonly.
“If there’s really no benefit and it may open a can of worms, then why are we doing it?” Hendel says.
Other routine tests that spot risk factors, such as high blood pressure and cholesterol, are much more useful in identifying people at elevated risk for heart attacks and strokes, the panel and others say.
Cardiovascular disease is the leading cause of death in the United States.