Prognostic implications of quantitative ST-segment characteristics and T-wave amplitude for cardiovascular mortality in a general population from the Health 2000 Survey.
OBJECTIVE
We determined the gender-specific prognostic importance of quantitative measures of the ST segment and T wave in a community cohort.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Anttila
Ismo
I
Division of Internal Medicine, Department of Cardiology, Sein&#x00E4;joki Central Hospital, Finland.
Nikus
Kjell
K
Kähönen
Mika
M
Jula
Antti
A
Reunanen
Antti
A
Salomaa
Veikko
V
Nieminen
Markku S
MS
Lehtimäki
Terho
T
Virtanen
Vesa
V
Verrier
Richard L
RL
Varis
Juha
J
Sclarovsky
Samuel
S
Nieminen
Tuomo
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000503:physiopathology; D004562:Electrocardiography / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006306:Health Surveys; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models