Regular paperImpact of minor electrocardiographic ST-segment and/or T-wave abnormalities on cardiovascular mortality during long-term follow-up☆
Section snippets
Study population
The Chicago Heart Association Detection Project in Industry is a prospective investigation of 39,573 women and men. The baseline survey was conducted from 1967 to 1973 in 84 cooperating companies and organizations in the Chicago area.16 The current analysis is limited to 18,972 Caucasian and African-American women and men, ages 40 to 64 years at baseline. Younger persons were excluded because of the small number of cardiovascular events in follow-up (especially in women). Older persons were
Baseline risk factor characteristics
Women and men with ST and/or T abnormalities, compared with those free of any ECG abnormality, were generally older and had higher serum cholesterol, blood pressures, 1-hour postload glucose, prevalence of diabetes, and hypertensive medication usage (Table 1).
Prevalence of ST and/or T abnormalities
The age-adjusted prevalence of minor T-wave abnormalities was 1.9% in women and 1.6% in men. For minor ST-segment depression only, the age-adjusted prevalence was 1.5% in women and 1.2% in men. These differences were not statistically
Discussion
This study demonstrated significant increases in age-adjusted risks of CHD, CVD, and total mortality over 22 years in women and men combined in association with isolated minor ST-segment and/or T-wave abnormalities. The combined analysis was justified by the absence of interaction by gender. Age-adjusted HRs—nearly all statistically significant—may be a better reflection of actual risk faced by patients due to possible over-adjustment in multivariate models, most of which showed some degree of
Acknowledgements
A list of colleagues who contributed to earlier aspects of this work has been published (Cardiology 1993;82:191–222).
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This work was supported by the American Heart Association, Dallas, Texas and by its Chicago and Illinois affiliates; grants HL 15174, HL 21010, and HL 03387 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland; and by the Chicago Health Research Foundation, Chicago, Illinois.