title: Coronary artery calcification and ECG pattern of left ventricular hypertrophy or strain identify different healthy individuals at risk.
abstract: OBJECTIVE
  To improve risk stratification for development of ischaemic heart disease, several markers have been proposed. Both the presence of coronary artery calcification (CAC) and ECG pattern of left ventricular hypertrophy/strain have been shown to provide independent prognostic information. In this study, we investigated the association between established risk factors, ECG measurements and the presence of coronary artery calcification.
  
  
  METHODS
  A random sample of healthy men and women aged 50 or 60 years were invited to the screening study. Established risk factors were measured. A noncontrast computed tomographic (CT) scan was performed to assess the CAC score. ECG analysis included left ventricular hypertrophy (LVH) using the Sokolow-Lyon criteria and the Cornell voltage × QRS duration product, and strain pattern based on ST segment depression and T-wave abnormalities. The association between the presence of CAC, clinical variables and ECG findings was evaluated by means of multivariate logistic regression.
  
  
  RESULTS
  Of 1825 invited individuals, 1226 accepted the screening. The prevalence of hypertension was 50%. Hypertensive patients frequently had LVH and/or strain when compared with nonhypertensive individuals (21 vs. 14%, P < 0.0001) as well as CAC (52 vs. 38%, P < 0.0001). In multiple logistic regressions analyses, there was no association between the ECG abnormalities and the presence of CAC.
  
  
  CONCLUSIONS
  There appears to be no relationship between CAC and ECG-suspected LVH and/or strain. We propose that these markers identify different individuals at risk and together may have additive prognostic value.
authors: Department of Cardiology, Odense University Hospital, Odense, Denmark.
authors: Søren Zöga
authors: SZ
authors: Diederichsen
authors: Oke
authors: O
authors: Gerke
authors: Michael Hecht
authors: MH
authors: Olsen
authors: Jess
authors: J
authors: Lambrechtsen
authors: Niels Peter Rønnow
authors: NP
authors: Sand
authors: Bjarne Linde
authors: BL
authors: Nørgaard
authors: Hans
authors: H
authors: Mickley
authors: Axel Cosmus Pyndt
authors: AC
authors: Diederichsen
mesh_terms: D002114:Calcinosis; D003331:Coronary Vessels / Q000473:pathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors