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August 2018

Does Resting or Exercise Electrocardiography Assist Clinicians in Preventing Cardiovascular Events in Asymptomatic Adults?

Author Affiliations
  • 1University of Arizona College of Medicine, Tucson
  • 2Editor in Chief, The American Journal of Medicine
JAMA Cardiol. 2018;3(8):678-679. doi:10.1001/jamacardio.2018.1800

This week in JAMA, the US Preventive Services Task Force (USPSTF) published a recommendation statement1 and evidence report2 for health care professionals concerning screening cardiovascular disease (CVD) using resting and exercise electrocardiography (ECG). This task force has authored many reports throughout the years involving a variety of possible screening approaches associated with the prevention of disease. The latest recommendations point out that a careful review of the medical literature failed to find any convincing evidence that resting or exercise ECG provided useful information for preventing CVD events in asymptomatic adults. I agree with the following statement but also find it curious because in more than 40 years as an internist/cardiologist, I had never heard anyone overtly state: screening asymptomatic individuals with a resting or exercise ECG would be of use in predicting CVD events and thereby help to prevent such events and improve clinical outcomes. However, the ECG is ubiquitous and often obtained unconsciously as part of a routine physical examination, and it is possible that many clinicians order these tests with the mistaken impression that the information in the ECG will be useful in preventing future cardiovascular events.

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