USPSTF: ECG screening still not recommended for low-risk adults
In an update to its 2004 statement, the US Preventive Services Task Force continues to recommend against using electrocardiography to screen for CHD in asymptomatic, low-risk adults.
Although research indicates that several resting and exercise ECG abnormalities are associated with an increased risk for CHD, the task force did not find that combining ECG results with conventional risk factor assessment would improve risk stratification.
“For asymptomatic adults at low risk for CHD events, the USPSTF found adequate evidence that the incremental information offered by resting or exercise ECG (beyond that obtained with conventional CHD risk factors) is highly unlikely to result in changes in risk stratification that would prompt interventions and, ultimately, reduce CHD-related events,” according to the updated statement.
ECG screening, in fact, may be linked to possible harms, the task force said, particularly related to potential adverse events associated with invasive tests.
Similarly, for intermediate- to high-risk, asymptomatic adults, evidence remains insufficient to evaluate the benefit of adding resting or exercise ECG to conventional risk factors to predict CHD events. Furthermore, the task force identified no evidence suggesting that ECG screening changes risk management in this population.
The USPSTF also identified gaps in research and areas that require more study.
“Studies that use a conventional risk stratification algorithm and evaluate the changes in risk classification treatment, and CHD outcomes that occur as a result of the addition of resting or exercise ECG are needed. There is a particular need for evidence to help understand restratification in persons who are at intermediate risk. Any study of screening should also evaluate harms associated with screening as well as harms related to additional testing and therapies,” the statement reads.
Currently, the American College of Cardiology and the American Heart Association take a slightly different stance, stating that a resting ECG is “reasonable for CV risk assessment in asymptomatic adults with hypertension or diabetes” and that an exercise ECG “may be considered for CV risk assessment in intermediate-risk asymptomatic adults (including sedentary adults considering starting a vigorous exercise program), particularly when attention is paid to non-ECG markers such as exercise capacity.”
Disclosure: The researchers report no relevant financial disclosures.