title: Prognostic implications of quantitative ST-segment characteristics and T-wave amplitude for cardiovascular mortality in a general population from the Health 2000 Survey.
abstract: 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.
authors.affiliation: Division of Internal Medicine, Department of Cardiology, Sein&#x00E4;joki Central Hospital, Finland.
authors.forename: Ismo
authors.initials: I
authors.lastname: Anttila
authors.forename: Kjell
authors.initials: K
authors.lastname: Nikus
authors.forename: Mika
authors.initials: M
authors.lastname: Kähönen
authors.forename: Antti
authors.initials: A
authors.lastname: Jula
authors.forename: Antti
authors.initials: A
authors.lastname: Reunanen
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
authors.forename: Markku S
authors.initials: MS
authors.lastname: Nieminen
authors.forename: Terho
authors.initials: T
authors.lastname: Lehtimäki
authors.forename: Vesa
authors.initials: V
authors.lastname: Virtanen
authors.forename: Richard L
authors.initials: RL
authors.lastname: Verrier
authors.forename: Juha
authors.initials: J
authors.lastname: Varis
authors.forename: Samuel
authors.initials: S
authors.lastname: Sclarovsky
authors.forename: Tuomo
authors.initials: T
authors.lastname: Nieminen
mesh_terms: 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