title: Association of isolated minor non-specific ST-segment and T-wave abnormalities with subclinical atherosclerosis in a middle-aged, biracial population: Coronary Artery Risk Development in Young Adults (CARDIA) study.
abstract: OBJECTIVE
  Isolated minor non-specific ST-segment and T-wave abnormalities (NSSTTAs) are common and known to be independent electrocardiographic risk markers for future cardiovascular disease (CVD) events. The association of NSSTTA with subclinical atherosclerosis is not well defined, but has been postulated as a potential mechanism of association with future clinical events.
  
  
  RESULTS
  We studied participants from the Year 20 examination of the middle-aged, biracial CARDIA cohort. This examination included measurement of traditional risk factors, 12-lead electrocardiograms (ECGs), coronary artery calcium (CAC) measurement and common carotid intima-media thickness (CC-IMT). ECGs were coded using both Minnesota Code (MC) and Novacode (NC) criteria. Isolated minor STTA was defined by MC as presence of MC 4-3, 4-4, 5-3, or 5-4, and by NC as presence of NC 5.8. ECGs with secondary causes of STTA (i.e., LVH) were excluded. Multivariable logistic regression was used to determine the cross-sectional association of isolated minor NSSTTAs with CAC and CC-IMT. The study sample consisted of 2175 participants with an average age of 45 years (57% female and 43% Black). Isolated NSSTTAs were present in 5.1% of males and 6.3% of females. No association was observed between NSSTTA and CAC. After multivariable-adjustment for traditional CVD risk factors, the presence of isolated minor NSSTTAs remained significantly associated with the extent of CC-IMT (odds ratio 1.25 (1.06-1.48), p < 0.01). This association remained significant after further adjustment for CAC.
  
  
  CONCLUSIONS
  Isolated minor NSSTTAs were associated with the extent of CC-IMT, but not with CAC, in this middle-aged biracial cohort. Further study is needed to elucidate potential mechanisms for these findings.
authors.affiliation: Bluhm Cardiovascular Institute, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Walsh
authors.forename: Ronald
authors.initials: R
authors.lastname: Prineas
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Hongyan
authors.initials: H
authors.lastname: Ning
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
authors.forename: Donald M
authors.initials: DM
authors.lastname: Lloyd-Jones
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D058070:Asymptomatic Diseases; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D061205:Vascular Calcification / Q000175:diagnosis / Q000208:ethnology; D044465:White People