Longitudinal association of electrocardiogram abnormalities with major adverse cardiac events in people with Type 2 diabetes: the Hoorn Diabetes Care System cohort

In this cohort study of 11 993 people with Type 2 diabetes (T2D) that were still free of cardiovascular disease (CVD), the people with electrocardiogram (ECG) abnormalities were up to four times as likely to experience heart failure and up to twice as likely to experience a heart attack, regardless of their age, sex, blood pressure, or estimated risk of CVD.• Most ECG abnormalities are related to a higher risk of heart failure, but only ECG abnormalities that indicate reduced oxygen supply to the heart are related to a higher risk of a heart attack.• Periodical ECG examinations can help detect developing heart disease in an early stage for all people with T2D still free of CVD.