title: Distinguishing between those dying suddenly or not suddenly from coronary heart disease: long-term prospective results from the Northwick Park Heart Study.
abstract: To establish whether ECG findings are associated with subsequent risk of sudden death from coronary heart disease (CHD).
  
  
  
  Potential risk factors for CHD were measured at entry to the first Northwick Park Heart Study of 2167 men. ECG findings were coded as high or low risk for CHD according to definitions in the Minnesota code. Sudden or non-sudden deaths were defined as occurring in less than or more than 24 hours, respectively. The only factor independently associated with sudden death among the 262 men dying of CHD was high-risk ECG. Of 184 sudden CHD deaths, 34 men (18.5%) had had high-risk ECGs at entry to the study compared with 5 (6.4%) of 78 men who experienced non-sudden deaths (adjusted OR 3.94 (95% CI 1.33 to 11.67)) (p=0.006). Findings were also compared among all 2167 men, where high-risk ECGs were again associated with sudden death. T-wave changes were the main abnormalities associated with a high risk of sudden death.
  
  
  
  In a group of men who had not previously experienced major episodes of CHD but who subsequently died from it, there was strong evidence that high-risk ECG changes, mainly T-wave abnormalities, differentiated between those who later died sudden deaths and those who survived for >24 hours.
authors.affiliation: Department of Non-Communicable Disease Epidemiology , London School of Hygiene and Tropical Medicine , London , UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Meade
authors.affiliation: Department of Medical Statistics , London School of Hygiene and Tropical Medicine , London , UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Clayton
authors.affiliation: Brighton and Sussex Medical School, University of Sussex , East Sussex, Brighton , UK.
authors.forename: Douglas
authors.initials: D
authors.lastname: Chamberlain