TY - JOUR
T1 - Association of nonspecific minor ST-T abnormalities with cardiovascular mortality
T2 - The Chicago western electric study
AU - Daviglus, Martha L.
AU - Liao, Youlian
AU - Greenland, Philip
AU - Dyer, Alan R.
AU - Liu, Kiang
AU - Xie, Xiaoyuan
AU - Huang, Cheng Fang
AU - Prineas, Ronald J.
AU - Stamler, Jeremiah
PY - 1999/2/10
Y1 - 1999/2/10
N2 - Context Minor electrocardiographic (ECG) ST-T abnormalities are common, but their prognostic importance has not been fully determined. Objective To examine associations of single (1 time only) and multiple (2 times only and ≥3 times) nonspecific minor ST-T abnormalities in 5 years with long-term mortality due to myocardial infarction (MI), coronary heart disease (CHD), cardiovascular disease (CVD), and all causes in middle-aged men. Design Prospective cohort study (29-year follow-up after 5 annual examinations). Setting and Participants A total of 1673 men employed at the Western Electric Company in Chicago, III, aged 40 to 55 years at entry, with no evidence of CHD and no major ECG abnormalities throughout the first 5-year period. Main Outcome Measures Minor ST-T abnormalities identified from annual resting ECGs and mortality ascertained from death certificates. Results Of the 1673 men, 173 had evidence of isolated nonspecific minor ST-T segment abnormalities. During the follow-up period, there were 234 deaths due to MI, 352 deaths due to CHD, 463 deaths due to CVD, and 889 deaths due to all causes. For men with 3 or more annual recordings of minor ST-T abnormalities, risk of death due to MI, CHD, CVD, and all causes was significantly greater than for those with normal ECG findings. For men with 3 or more ECGs with minor ST-T abnormalities, relative risks (and 95% confidence intervals) adjusted for cardiovascular and other risk factors were 2.28 (1.16-4.49), 2.39 (1.39- 4.12), 2.30 (1.44-3.68), and 1.60 (1.06 2.42), respectively, with a graded relationship between frequency of occurrence of ST-T abnormalities and mortality risk (linear trend, P≤.007). Conclusions Persistent, minor, nonspecific ST-T abnormalities are associated with increased long-term risk of mortality due to MI, CHD, CVD, and all causes; the higher the frequency of occurrence of minor ST-T abnormalities, the greater the risk. These data underscore the potential value of including nonspecific ECG findings in the over-all assessment of cardiovascular risk.
AB - Context Minor electrocardiographic (ECG) ST-T abnormalities are common, but their prognostic importance has not been fully determined. Objective To examine associations of single (1 time only) and multiple (2 times only and ≥3 times) nonspecific minor ST-T abnormalities in 5 years with long-term mortality due to myocardial infarction (MI), coronary heart disease (CHD), cardiovascular disease (CVD), and all causes in middle-aged men. Design Prospective cohort study (29-year follow-up after 5 annual examinations). Setting and Participants A total of 1673 men employed at the Western Electric Company in Chicago, III, aged 40 to 55 years at entry, with no evidence of CHD and no major ECG abnormalities throughout the first 5-year period. Main Outcome Measures Minor ST-T abnormalities identified from annual resting ECGs and mortality ascertained from death certificates. Results Of the 1673 men, 173 had evidence of isolated nonspecific minor ST-T segment abnormalities. During the follow-up period, there were 234 deaths due to MI, 352 deaths due to CHD, 463 deaths due to CVD, and 889 deaths due to all causes. For men with 3 or more annual recordings of minor ST-T abnormalities, risk of death due to MI, CHD, CVD, and all causes was significantly greater than for those with normal ECG findings. For men with 3 or more ECGs with minor ST-T abnormalities, relative risks (and 95% confidence intervals) adjusted for cardiovascular and other risk factors were 2.28 (1.16-4.49), 2.39 (1.39- 4.12), 2.30 (1.44-3.68), and 1.60 (1.06 2.42), respectively, with a graded relationship between frequency of occurrence of ST-T abnormalities and mortality risk (linear trend, P≤.007). Conclusions Persistent, minor, nonspecific ST-T abnormalities are associated with increased long-term risk of mortality due to MI, CHD, CVD, and all causes; the higher the frequency of occurrence of minor ST-T abnormalities, the greater the risk. These data underscore the potential value of including nonspecific ECG findings in the over-all assessment of cardiovascular risk.
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U2 - 10.1001/jama.281.6.530
DO - 10.1001/jama.281.6.530
M3 - Review article
C2 - 10022109
AN - SCOPUS:0033540639
SN - 0098-7484
VL - 281
SP - 530
EP - 536
JO - JAMA
JF - JAMA
IS - 6
ER -