title: T axis as an indicator of risk of cardiac events in elderly people.
abstract: BACKGROUND
  The T axis was postulated to be a general marker of repolarisation abnormality, indicative of subclinical myocardial damage. The aim of this investigation was to assess the prognostic importance of the T axis for fatal and non-fatal cardiac events, in a prospective cohort study of men and women aged 55 years and older.
  
  
  METHODS
  2352 men and 3429 women from the population-based Rotterdam Study took part in the study. Electrocardiograms were done, and T axes were categorised as normal, borderline, or abnormal. Data were analysed with Cox's proportional-hazards models; adjustment for age and sex was done where appropriate.
  
  
  RESULTS
  During 3-6 (mean 4) years of follow-up of the 5781 participants, 165 (2.9%) fatal and 192 (3.3%) non-fatal cardiac events occurred. Participants with an abnormal T axis (n=609) had an increased risk of cardiac death (hazard ratio 3.9 [95% CI 2.8-5.6]), sudden cardiac death (4.4 [2.6-7.4]), non-fatal cardiac events (2.7 [1.9-3.9]), and combined fatal or non-fatal cardiac events (3.2 [2.5-4.1]); p<0.001 for each. Additional adjustment for established cardiovascular risk factors resulted in lower, but still significant risk for all endpoints. The risk associated with an abnormal T axis was higher than those for any other cardiovascular risk factor. Additional subgroup analyses indicated that the risk of cardiac death was not substantially modified by age, sex, or history of myocardial infarction.
  
  
  CONCLUSIONS
  The T axis is a strong and independent risk indicator of fatal and non-fatal cardiac events in the elderly.
authors.affiliation: Department of Medical Informatics, Erasmus University Medical School, Rotterdam, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Kors
authors.forename: M C
authors.initials: MC
authors.lastname: de Bruyne
authors.forename: A W
authors.initials: AW
authors.lastname: Hoes
authors.forename: G
authors.initials: G
authors.lastname: van Herpen
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.forename: J H
authors.initials: JH
authors.lastname: van Bemmel
authors.forename: D E
authors.initials: DE
authors.lastname: Grobbee
mesh_terms: D000368:Aged; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000453:epidemiology*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors