Polyscore of autonomic parameters for risk stratification of the elderly general population: the Polyscore study

STEGER, Alexander, Michael DOMMASCH, Alexander MULLER, Daniel SINNECKER, Katharina M. HUSTER, Teresa GOTZLER, Othmar GOTZLER, Alexander HAPFELMEIER, Kurt ULM, Petra BARTHEL, Katerina HNATKOVA, Karl-Ludwig LAUGWITZ, Marek MALÍK and Georg SCHMIDT. Polyscore of autonomic parameters for risk stratification of the elderly general population: the Polyscore study. Europace. Oxford: Oxford University Press, 2021, vol. 23, No 5, p. 789-796. ISSN 1099-5129. Available from: https://dx.doi.org/10.1093/europace/euaa359.

Basic information

• Original name: Polyscore of autonomic parameters for risk stratification of the elderly general population: the Polyscore study
• Authors: STEGER, Alexander, Michael DOMMASCH, Alexander MULLER, Daniel SINNECKER, Katharina M. HUSTER, Teresa GOTZLER, Othmar GOTZLER, Alexander HAPFELMEIER, Kurt ULM, Petra BARTHEL, Katerina HNATKOVA (203 Czech Republic), Karl-Ludwig LAUGWITZ, Marek MALÍK (203 Czech Republic, belonging to the institution) and Georg SCHMIDT.
• Edition: Europace, Oxford, Oxford University Press, 2021, 1099-5129.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30201 Cardiac and Cardiovascular systems
• Country of publisher: United Kingdom of Great Britain and Northern Ireland
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 5.486
• RIV identification code: RIV/00216224:14110/21:00121829
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1093/europace/euaa359
• UT WoS: 000657483300019
• Keywords in English: Elderly general population; Prospective validation; Autonomic markers; Risk assessment; Polyscore
• Tags: 14110211, rivok
• Tags: International impact, Reviewed

Abstract

Aims Present society is constantly ageing and elderly frequently suffer from conditions that are difficult and/or costly to treat if detected late. Effective screening of the elderly is therefore needed so that those requiring detailed clinical work-up are identified early. We present a prospective validation of a screening strategy based on a Polyscore of seven predominantly autonomic, non-invasive risk markers. Methods and results Within a population-based survey in Germany (INVADE study), participants aged >= 60 years were enrolled between August 2013 and February 2015. Seven prospectively defined Polyscore components were obtained during 30-min continuous recordings of electrocardiogram, blood pressure, and respiration. Out of 1956 subjects, 168 were excluded due to atrial fibrillation, implanted pacemaker, or unsuitable recordings. All-cause mortality over a median 4-year follow-up was prospectively defined as the primary endpoint. The Polyscore divided the investigated population (n= 1788, median age: 72 years, females: 58%) into three predefined groups with low (n= 1405, 78.6%), intermediate (n = 326, 18.2%), and high risk (n = 57, 3.2%). During the follow-up, 82 (4.6%) participants died. Mortality in the Polyscore-defined risk groups was 3.4%, 7.4%, and 17.5%, respectively (P <0.0001). The Polyscore-based mortality prediction was independent of Framingham score, diabetes, chronic kidney disease, and major stroke and/or myocardial infarction history. It was particularly effective in those aged <75 years (n = 1145). Conclusion The Polyscore-based mortality risk assessment from short-term non-invasive recordings is effective in the elderly general population, especially those aged 60-74 years. Implementation of a comprehensive Polyscore screening of this age group is proposed to advance preventive medical care.