Journal
CIRCULATION
Volume 118, Issue 25, Pages 2790-2796Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCULATIONAHA.108.772541
Keywords
death, sudden; electrocardiography; epidemiology; myocardial infarction; prognosis; risk
Funding
- National Heart, Lung, and Blood Institute, with additional contribution from the National Institute of Neurological Disorders and Stroke [N01-HC-85079, N01-HC-85086, N01-HC-35129, N01HC-15103, N01 HC-55222, N01-HC-75150, N01-HC45133, U01 HL080295]
- National Institute on Aging [R01 AG-15928, AG-20098, AG-027058]
- National Heart, Lung and Blood Institute [R01 HL-075366]
- University of Pittsburgh Claude D. Pepper Older Americans Independence Center [P30-AG-024827]
Ask authors/readers for more resources
Background-The prevalence and prognostic significance of isolated minor nonspecific ST-segment and T-wave abnormalities (NSSTTAs) in older adults are poorly understood. Methods and Results-Cardiovascular Health Study participants free of both clinical cardiovascular disease and major ECG abnormalities were included. We examined the prospective association of isolated minor NSSTTAs (defined by Minnesota Codes 4-3, 4-4, 5-3, and 5-4) with total, cardiovascular, and coronary mortality and incident nonfatal myocardial infarction. Among 3224 participants (61.9% women; mean age, 72 years), 233 (7.2%) had isolated NSSTTAs at baseline. Covariates associated with isolated NSSTTAs included older age, nonwhite race (20.5% of blacks versus 4.8% of whites; P<0.001), diabetes, and higher blood pressure and body mass index but not the presence of subclinical cardiovascular disease. After 39 518 person-years of follow-up, the presence of isolated NSSTTAs was associated with significantly increased risk for coronary heart disease mortality (multivariable-adjusted hazards ratio, 1.76; 95% CI, 1.18 to 2.61) but not with incident nonfatal myocardial infarction (multivariable-adjusted hazards ratio, 0.71; 95% CI, 0.43 to 1.17). The association of isolated NSSTTAs with coronary death was independent of subclinical atherosclerosis and left ventricular mass measures. In secondary analyses, among those with cardiac death, there was a significantly higher rate of primary arrhythmic death (32.3% versus 15.4%; P=0.02) in participants with isolated NSSTTAs versus those without NSSTTAs. Conclusions-Isolated NSSTTAs are common in older Americans and are associated with significantly increased risk for coronary death. However, isolated NSSTTAs are not associated with incident nonfatal myocardial infarction, suggesting that they are associated particularly with increased risk for primary arrhythmic death. (Circulation. 2008;118:2790-2796.)
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available