Impact of minor electrocardiographic ST-segment and/or T-wave abnormalities on cardiovascular mortality during long-term follow-up

Philip Greenland*, Xiaoyuan Xie, Kiang Liu, Laura Colangelo, Youlian Liao, Martha L. Daviglus, Abby N. Agulnek, Jeremiah Stamler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

92 Scopus citations

Abstract

Minor ST-T abnormalities are common on the resting electrocardiogram of otherwise healthy persons, but the long-term importance of these findings has not been extensively evaluated, especially in women. In a prospective study, 7,985 women and 9,630 men (aged 40 to 64 years at baseline) without other electrocardiographic abnormalities and free of previous coronary heart disease (CHD) were studied using Cox regression for 22-years of follow-up. Primary outcomes were death from CHD and total cardiovascular disease (CVD); total mortality was a secondary outcome. Minnesota Code was employed to assess the presence or absence of electrocardiographic abnormalities. Analyses compared persons with minor Minnesota Code ST-segment (codes 4-3 or 4-4) or T-wave findings (codes 5-3 or 5-4) to those with normal electrocardiographic findings. In combined analyses of men and women adjusted for age, isolated minor T-wave abnormality, minor ST-segment depression, or a combination of minor ST-segment and T-wave abnormalities were each associated with increased mortality risks. For CHD mortality, hazard ratios (HRs) ranged from 1.60 to 2.10; for CVD mortality, HRs ranged from 1.50 to 1.95; and for total mortality, HRs ranged from 1.31 to 1.50 (p <0.05 for all HRs). In separate analyses by gender adjusted for age, increased risks were observed for combined ST-T-wave abnormalities in both genders for CHD and CVD mortality (HR 1.72 to 1.75 for men, p <0.05; HR 2.07 to 2.51 for women, p <0.001). These data indicate that nonspecific (minor) ST-segment depression and/or T-wave abnormalities have a long-term prognostic impact for CHD and CVD death in middle-aged women and men and can be considered markers of heightened CHD and CVD risk.

Original languageEnglish (US)
Pages (from-to)1068-1074
Number of pages7
JournalAmerican Journal of Cardiology
Volume91
Issue number9
DOIs
StatePublished - May 1 2003

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Impact of minor electrocardiographic ST-segment and/or T-wave abnormalities on cardiovascular mortality during long-term follow-up'. Together they form a unique fingerprint.

Cite this