title: Prognostic value of q wave for cardiovascular death in a 19-year prospective study of the Japanese general population.
abstract: OBJECTIVE
  Little is known about the prognostic value of q wave abnormality for cardiovascular disease (CVD) on a resting electrocardiogram (ECG) of the Japanese general population with an extremely low incidence of myocardial infarction.
  
  
  METHODS
  We followed 8,339 participants without a past and present history of CVD for 19 years. The multivariate-adjusted hazard ratio (HR) of q wave abnormality for CVD mortality was estimated by the Cox proportional hazards model.
  
  
  RESULTS
  The multivariate-adjusted HR of composite findings of moderate or severe q wave abnormality was 1.75 (95% confidence interval (CI): 0.97-3.17) for mortality due to CVD and 2.97 (95%CI: 1.43-6.16) due to heart diseases. The multivariate-adjusted HR of mild abnormality for mortality from heart diseases was 1.95 (95%CI: 1.00-3.81). The relationship between moderate or severe abnormalities and mortality from CVD was unchanged when participants with ST-T changes and high amplitude R waves were excluded and when participants were divided by the presence of major CVD risk factors such as hypertension. Q wave abnormality was not associated with the risk of stroke.
  
  
  CONCLUSIONS
  Moderate or severe q wave abnormalities are prominent and important predictors of mortality due to CVD and heart disease in the Japanese general population without CVD history.
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Ostu, Japan. ahigashi@hsp.ncvc.go.jp
authors.forename: Aya
authors.initials: A
authors.lastname: Higashiyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hozawa
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Murakami
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Takehito
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Kadowaki
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Kita
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
mesh_terms: D044466:Asian People; D003643:Death; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies