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Prevalence, prognosis, and implications of isolated minor nonspecific ST-segment and T-wave abnormalities in older adults: Cardiovascular Health Study.
Tuesday,2012-11-06 12:10 America/Los_Angeles — eenright
| Title | Prevalence, prognosis, and implications of isolated minor nonspecific ST-segment and T-wave abnormalities in older adults: Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2008 |
| Authors | Kumar, A, Prineas, RJ, Arnold, AM, Psaty, BM, Furberg, CD, Robbins, J, Lloyd-Jones, DM |
| Journal | Circulation |
| Volume | 118 |
| Issue | 25 |
| Pagination | 2790-6 |
| Date Published | 2008 Dec 16 |
| ISSN | 1524-4539 |
| Keywords | Age Factors, Aged, Arrhythmias, Cardiac, Cardiovascular Diseases, Cohort Studies, Electrocardiography, Female, Health Status, Humans, Male, Middle Aged, Prevalence, Prognosis, Prospective Studies |
| Abstract | <p><b>BACKGROUND: </b>The prevalence and prognostic significance of isolated minor nonspecific ST-segment and T-wave abnormalities (NSSTTAs) in older adults are poorly understood.</p><p><b>METHODS AND RESULTS: </b>Cardiovascular Health Study participants free of both clinical cardiovascular disease and major ECG abnormalities were included. We examined the prospective association of isolated minor NSSTTAs (defined by Minnesota Codes 4-3, 4-4, 5-3, and 5-4) with total, cardiovascular, and coronary mortality and incident nonfatal myocardial infarction. Among 3224 participants (61.9% women; mean age, 72 years), 233 (7.2%) had isolated NSSTTAs at baseline. Covariates associated with isolated NSSTTAs included older age, nonwhite race (20.5% of blacks versus 4.8% of whites; P<0.001), diabetes, and higher blood pressure and body mass index but not the presence of subclinical cardiovascular disease. After 39 518 person-years of follow-up, the presence of isolated NSSTTAs was associated with significantly increased risk for coronary heart disease mortality (multivariable-adjusted hazards ratio, 1.76; 95% CI, 1.18 to 2.61) but not with incident nonfatal myocardial infarction (multivariable-adjusted hazards ratio, 0.71; 95% CI, 0.43 to 1.17). The association of isolated NSSTTAs with coronary death was independent of subclinical atherosclerosis and left ventricular mass measures. In secondary analyses, among those with cardiac death, there was a significantly higher rate of primary arrhythmic death (32.3% versus 15.4%; P=0.02) in participants with isolated NSSTTAs versus those without NSSTTAs.</p><p><b>CONCLUSIONS: </b>Isolated NSSTTAs are common in older Americans and are associated with significantly increased risk for coronary death. However, isolated NSSTTAs are not associated with incident nonfatal myocardial infarction, suggesting that they are associated particularly with increased risk for primary arrhythmic death.</p> |
| DOI | 10.1161/CIRCULATIONAHA.108.772541 |
| Alternate Journal | Circulation |
| PubMed ID | 19064684 |
| PubMed Central ID | PMC2729590 |
| Grant List | N01 HC085086 / HC / NHLBI NIH HHS / United States P30 AG024827 / AG / NIA NIH HHS / United States R01 AG-15928 / AG / NIA NIH HHS / United States P30 AG024827-05 / AG / NIA NIH HHS / United States R01 HL075366 / HL / NHLBI NIH HHS / United States R01 AG015928-02 / AG / NIA NIH HHS / United States U01 HL080295-04 / HL / NHLBI NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States R01 HL-075366 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States P30-AG-024827 / AG / NIA NIH HHS / United States R01 AG027058-03 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States R01 HL075366-05 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States AG-027058 / AG / NIA NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States R01 AG020098-06A2 / AG / NIA NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States R01 AG-20098 / AG / NIA NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States R01 HL086792-02 / HL / NHLBI NIH HHS / United States R01 HL086792 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States |