The USPSTF concludes that the curre

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening with resting or exercise ECG for the prediction of CHD events in asymptomatic adults at intermediate or high risk for CHD events (I statement).
See the Figure for a summary of the recommendations and suggestions for clinical practice.
Table 1 describes the USPSTF grades, and Table 2 describes the USPSTF classification of levels of certainty about net benefit.



RATIONALE
Importance
Coronary heart disease is the leading cause of death in the United States in both men and women, accounting for nearly 16% of all deaths each year. More than 1 million Americans have nonfatal or fatal myocardial infarction (MI) or sudden death from CHD annually. For some peo- ple, these events are the first manifestations of CHD.

Detection
The USPSTF found adequate evidence that many rest- ing and exercise ECG abnormalities are associated with an increased risk for a serious CHD event, after controlling for conventional risk factors.
There is inadequate evidence that adding ECG to con- ventional risk factor assessment leads to improved stratifi- cation of individuals into high-, intermediate-, or low-risk groups to guide risk management.