title: Electrocardiographic precordial ST-segment deviations and the risk of cardiovascular death: results from the Copenhagen ECG Study.
abstract: BACKGROUND
  We sought to perform a study assessing the association between electrocardiographic ST-segment deviations and cardiovascular death (CVD), in relation to sex and age (≥ and <65 years), in a large primary care population without overt ischemic heart disease.
  
  
  RESULTS
  Using computerized analysis of ECGs from 285 194 persons, we evaluated the association between precordial ST-segment deviations and the risk of CVD. All data on medication, comorbidity, and outcomes were retrieved from Danish registries. After a median follow-up period of 5.8 years, there were 6679 cardiovascular deaths. Increasing ST-depression was associated with an increased risk of CVD in almost all of the precordial leads, with the most robust association seen in lead V5 to V6. ST-elevations in lead V2 to V6 were associated with increased risk of CVD in young women, but not in men. However, ST-elevations in V1 increased the risk for both genders and age groups, exemplified by a HR of 1.80 (95% CI [1.19 to 2.74], P=0.005) for men <65 years with ST-elevations ≥ 150 μV versus a nondeviating ST-segment (-50 μV to +50 μV). In contrast, for men <65 years, ST-elevations in lead V2 to V3 conferred a decreased risk of CVD with a HR of 0.77 (95% CI [0.62 to 0.96], P<0.001) for ST-elevations ≥ 150 μV in V2.
  
  
  CONCLUSIONS
  We found that ST-depressions were associated with a dose-responsive increased risk of CVD in nearly all the precordial leads. ST-elevations conferred an increased risk of CVD in women and with regard to lead V1 also in men. However, ST-elevations in V2 to V3 were associated with a decreased risk of CVD in young men.
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia.
authors.forename: Peter Vibe
authors.initials: PV
authors.lastname: Rasmussen
authors.forename: Jonas Bille
authors.initials: JB
authors.lastname: Nielsen
authors.forename: Adrian
authors.initials: A
authors.lastname: Pietersen
authors.forename: Claus
authors.initials: C
authors.lastname: Graff
authors.forename: Bent
authors.initials: B
authors.lastname: Lind
authors.forename: Johannes Jan
authors.initials: JJ
authors.lastname: Struijk
authors.forename: Morten Salling
authors.initials: MS
authors.lastname: Olesen
authors.forename: Stig
authors.initials: S
authors.lastname: Haunsø
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Jesper Hastrup
authors.initials: JH
authors.lastname: Svendsen
authors.forename: Anders Gaarsdal
authors.initials: AG
authors.lastname: Holst
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000503:physiopathology; D003718:Denmark / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors
keywords: Brugada; ECG; Marquette 12SL validation; ST‐segment; gender differences; general population