Echocardiographic screening of the general population and long-term survival: a randomized clinical study

Abstract

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.