title: Electrocardiographic repolarization-related variables as predictors of coronary heart disease death in the women's health initiative study.
abstract: BACKGROUND
  We evaluated 25 repolarization-related ECG variables for the risk of coronary heart disease (CHD) death in 52 994 postmenopausal women from the Women's Health Initiative study.
  
  
  RESULTS
  Hazard ratios from Cox regression were computed for subgroups of women with and without cardiovascular disease (CVD). During the average follow-up of 16.9 years, 941 CHD deaths occurred. Based on electrophysiological considerations, 2 sets of ECG variables with low correlations were considered as candidates for independent predictors of CHD death: Set 1, Ѳ(Tp|Tref), the spatial angle between T peak (Tp) and normal T reference (Tref) vectors; Ѳ(Tinit|Tterm), the angle between the initial and terminal T vectors; STJ depression in V6 and rate-adjusted QTp interval (QTpa); and Set 2, TaVR and TV1 amplitudes, heart rate, and QRS duration. Strong independent predictors with over 2-fold increased risk for CHD death in women with and without CVD were Ѳ(Tp|Tref) >42° from Set 1 and TaVR amplitude >-100 μV from Set 2. The risk for these CHD death predictors remained significant after multivariable adjustment for demographic/clinical factors. Other significant predictors for CHD death in fully adjusted risk models were Ѳ(Tinit|Tterm) >30°, TV1 >175 μV, and QRS duration >100 ms.
  
  
  CONCLUSIONS
  Ѳ(Tp|Tref) angle and TaVR amplitude are associated with CHD mortality in postmenopausal women. The use of these measures to identify high-risk women for further diagnostic evaluation or more intense preventive intervention warrants further study.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT00000611.
authors: Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (P.M.R., Z.M.Z., E.Z.S.).
authors: Pentti M
authors: PM
authors: Rautaharju
authors: Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (P.M.R., Z.M.Z., E.Z.S.).
authors: Zhu-Ming
authors: ZM
authors: Zhang
authors: Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (M.V.).
authors: Mara
authors: M
authors: Vitolins
authors: Cardiac Electrophysiology and Arrhythmia Service, Stanford University Medical Center, Stanford, CA (M.P.).
authors: Marco
authors: M
authors: Perez
authors: Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA (M.A.A.).
authors: Matthew A
authors: MA
authors: Allison
authors: Departments of Preventive Medicine and Medicine-Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.).
authors: Philip
authors: P
authors: Greenland
authors: Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (P.M.R., Z.M.Z., E.Z.S.) Section on Cardiology, Department of Medicine, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.).
authors: Elsayed Z
authors: EZ
authors: Soliman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D015331:Cohort Studies; D003327:Coronary Disease / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000002:abnormalities* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
keywords: coronary heart disease; electrocardiography; mortality; repolarization; risk factors