title: Isolated negative T waves in the general population is a powerful predicting factor of cardiac mortality and coronary heart disease.
abstract: BACKGROUND
  Isolated negative T waves (INTW) are considered a common and minor electrocardiographic (ECG) abnormality. However, few recent studies have associated the presence of INTW with an increased risk of all-causes and cardiovascular mortalities. The aim was to evaluate the predictive value of INTW for coronary heart disease (CHD) and all-cause mortality.
  
  
  METHODS
  Between 1991 and 1994, 12-lead ECGs were recorded in a sample of 10,600 men (PRIME Study). Among them, 1284 (12.1%) were excluded because of major ECG abnormalities at entry according to Minnesota code, a history of CHD or likely ischemic chest pain on the Rose Questionnaire. INTW were found in 256 subjects (2.74%). The primary outcome was myocardial infarction and angina pectoris after a 10 year follow-up (9.6 ± 1.4). Secondary outcome was all causes of death.
  
  
  RESULTS
  After multivariate adjustment, INTW < 1 mm in anterior or inferior leads was associated with a higher risk of angina pectoris [HR 3.04 95% CI (1.13-8.22) and HR 3.67 95% CI (1.35-9.96) respectively] and INTW ≥ 1 mm in lateral or anterior leads were associated with a higher incidence of myocardial infarction [HR 2.75, 95% CI (1.29-5.88) and HR 3.20 95% CI (1.68-6.09) respectively]. The association of INTW ≥ 1 mm in leads V1 to V5 with mortality remained highly significant [HR 3.17 95% CI (1.77-5.65)] after multivariate adjustment.
  
  
  CONCLUSIONS
  In middle-age men, INTW is associated with a 2 to 3-fold higher risk of death, myocardial infarction and angina pectoris.
authors.affiliation: Department of Cardiology B, Toulouse University Hospital (CHU), Toulouse, France; Department of Epidemiology, Health Economics and Public Health, UMR1027 INSERM-University of Toulouse III, Toulouse University Hospital (CHU), Toulouse, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Rollin
authors.affiliation: Department of Cardiology B, Toulouse University Hospital (CHU), Toulouse, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Maury
authors.affiliation: UK Clinical Research Collaboration (UKCRC) Centre of Excellence for Public Health Research (NI), Queen's University of Belfast, Belfast, Ireland.
authors.forename: Frank
authors.initials: F
authors.lastname: Kee
authors.affiliation: Department of Epidemiology and Public Health, INSERM UMR744, Pasteur Institute of Lille, University Lille Nord de France - UDSL, Lille, France.
authors.forename: Michèle
authors.initials: M
authors.lastname: Montaye
authors.affiliation: Department of Epidemiology and Public Health, EA 3430, FMTS, University of Strasbourg, Strasbourg, France.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Haas
authors.affiliation: UK Clinical Research Collaboration (UKCRC) Centre of Excellence for Public Health Research (NI), Queen's University of Belfast, Belfast, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Yarnell
authors.affiliation: Department of Epidemiology and Public Health, EA 3430, FMTS, University of Strasbourg, Strasbourg, France; Department of Public Health, Strasbourg University Hospital, Strasbourg, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Arveiler
authors.affiliation: Department of Epidemiology and Public Health, INSERM UMR744, Pasteur Institute of Lille, University Lille Nord de France - UDSL, Lille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Amouyel
authors.affiliation: UK Clinical Research Collaboration (UKCRC) Centre of Excellence for Public Health Research (NI), Queen's University of Belfast, Belfast, Ireland.
authors.forename: Alun
authors.initials: A
authors.lastname: Evans
authors.affiliation: Université Paris Sud-XI, Villejuif, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Ducimetière
authors.affiliation: Department of Cardiology B, Toulouse University Hospital (CHU), Toulouse, France; Department of Epidemiology, Health Economics and Public Health, UMR1027 INSERM-University of Toulouse III, Toulouse University Hospital (CHU), Toulouse, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrières
authors.affiliation: Department of Epidemiology, Health Economics and Public Health, UMR1027 INSERM-University of Toulouse III, Toulouse University Hospital (CHU), Toulouse, France. Electronic address: jean-bernard.ruidavets@univ-tlse3.fr.
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Ruidavets
mesh_terms: D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: Cohort study; Electrocardiogram; Mortality; Myocardial infarction