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Original Investigation |

Echocardiographic Screening of the General Population and Long-term Survival:  A Randomized Clinical Study

Haakon Lindekleiv, MD, PhD1; Maja-Lisa Løchen, MD, PhD1,3; Ellisiv B. Mathiesen, MD, PhD2,4; Inger Njølstad, MD, PhD2; Tom Wilsgaard, PhD2; Henrik Schirmer, MD, PhD2,3
[+] Author Affiliations
1Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
2Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
3Division of Cardiology, University Hospital of North Norway, Tromsø
4Division of Neurology, University Hospital of North Norway, Tromsø
JAMA Intern Med. 2013;173(17):1592-1598. doi:10.1001/jamainternmed.2013.8412.
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Importance  Identification of structural heart disease in asymptomatic individuals could allow early disease-modifying treatment.

Objective  To examine whether echocardiographic screening in the general population improves long-term survival or reduces the risk of cardiovascular disease.

Design, Setting, and Participants  We studied 6861 middle-aged participants from the population-based Tromsø Study in Norway.

Intervention  Participants were randomly allocated to an echocardiographic screening group (n = 3272) or a control group (n = 3589).

Main Outcomes and Measures  Using the as-treated approach, the data were analyzed for mortality and incidence of fatal and nonfatal myocardial infarction and stroke.

Results  During 15 follow-up years, 880 persons (26.9%) in the screening group and 989 persons (27.6%) in the control group died (hazard ratio, 0.97; 95% CI, 0.89-1.06). No significant differences between the groups were observed in the secondary outcome measures (sudden death, mortality from any heart disease, or incidence of fatal and nonfatal myocardial infarction and stroke).

Conclusions and Relevance  Echocardiographic screening for structural and valvular heart disease in the general population provided no benefit for mortality or for the risk of myocardial infarction or stroke.

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Figure.
Kaplan-Meier Survival Plots of the Screening Group and the Control Group

The Tromsø Study, 1994 to 2009.

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