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Prognostic implications of quantitative ST-segment characteristics and T-wave amplitude for cardiovascular mortality in a general population from the Health 2000 Survey.

https://arctichealth.org/en/permalink/ahliterature140673
Source
Ann Med. 2010 Oct;42(7):502-11
Publication Type
Article
Date
Oct-2010
Author
Ismo Anttila
Kjell Nikus
Mika Kähönen
Antti Jula
Antti Reunanen
Veikko Salomaa
Markku S Nieminen
Terho Lehtimäki
Vesa Virtanen
Richard L Verrier
Juha Varis
Samuel Sclarovsky
Tuomo Nieminen
Author Affiliation
Division of Internal Medicine, Department of Cardiology, Seinäjoki Central Hospital, Finland.
Source
Ann Med. 2010 Oct;42(7):502-11
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cardiovascular Diseases - mortality - physiopathology
Electrocardiography - statistics & numerical data
Female
Finland - epidemiology
Health Surveys
Heart Conduction System - physiopathology
Humans
Hypertrophy, Left Ventricular - physiopathology
Male
Middle Aged
Predictive value of tests
Prognosis
Proportional Hazards Models
Abstract
We determined the gender-specific prognostic importance of quantitative measures of the ST segment and T wave in a community cohort.
Data were collected from 5613 Finnish individuals. Four electrocardiogram (ECG) lead groups were used: anterior, lateral, inferior, and lead V5. ST-segment depression, determined at four points along the ST segment, and T-wave amplitude were treated as continuous variables in Cox regression analyses.
During a median follow-up period of 72.4 months, 120 cardiovascular deaths were registered. Among women, lateral lead group as well as lead V5 showed highly significant adjusted hazard ratios at all four ST-depression assessment points. This significance was lost in women = 55 years when those with ECG-based criteria of left ventricular hypertrophy (LVH) were excluded. Results for ST-segment depression were not significant among men. As those with LVH were excluded, men = 55 years showed borderline significance. T-wave amplitude did not reach significance among men, while lateral leads and lead V5 bore prognostic information among women.
Quantitative ST-segment depression, regardless of the measurement point, allows prediction of cardiovascular death in women within a general population. However, the effect disappears as those with LVH are excluded. This observation highlights the need for consideration of LVH when depressed ST segments are clinically observed.
PubMed ID
20854212 View in PubMed
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