Electrocardiographic Precordial ST‐Segment Deviations and the Risk of Cardiovascular Death: Results From the Copenhagen ECG Study

Peter Vibe Rasmussen; Jonas Bille Nielsen; Adrian Pietersen; Claus Graff; Bent Lind; Johannes Jan Struijk; Morten Salling Olesen; Stig Haunsø; Lars Køber; Jesper Hastrup Svendsen; Anders Gaarsdal Holst

doi:10.1161/JAHA.113.000549

Electrocardiographic Precordial ST‐Segment Deviations and the Risk of Cardiovascular Death: Results From the Copenhagen ECG Study

Peter Vibe Rasmussen, Jonas Bille Nielsen, Adrian Pietersen, Claus Graff, Bent Lind, Johannes Jan Struijk, Morten Salling Olesen, Stig Haunsø, Lars Køber, Jesper Hastrup Svendsen, Anders Gaarsdal Holst

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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. Methods and 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, STelevations 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. Conclusion-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, STelevations in V2 to V3 were associated with a decreased risk of CVD in young men.

Originalsprog	Engelsk
Artikelnummer	e000549
Tidsskrift	American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease
Vol/bind	3
Udgave nummer	3
Sider (fra-til)	1-16
Antal sider	16
ISSN	2047-9980
DOI	https://doi.org/10.1161/JAHA.113.000549
Status	Udgivet - jun. 2014

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10.1161/JAHA.113.000549Licens: CC BY-NC

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Rasmussen, P. V., Nielsen, J. B., Pietersen, A., Graff, C., Lind, B., Struijk, J. J., Olesen, M. S., Haunsø, S., Køber, L., Svendsen, J. H., & Holst, A. G. (2014). Electrocardiographic Precordial ST‐Segment Deviations and the Risk of Cardiovascular Death: Results From the Copenhagen ECG Study. American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease, 3(3), 1-16. Artikel e000549. https://doi.org/10.1161/JAHA.113.000549

Electrocardiographic Precordial ST‐Segment Deviations and the Risk of Cardiovascular Death: Results From the Copenhagen ECG Study. / Rasmussen, Peter Vibe; Nielsen, Jonas Bille; Pietersen, Adrian et al.
I: American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease, Bind 3, Nr. 3, e000549, 06.2014, s. 1-16.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Rasmussen, PV, Nielsen, JB, Pietersen, A, Graff, C, Lind, B, Struijk, JJ, Olesen, MS, Haunsø, S, Køber, L, Svendsen, JH & Holst, AG 2014, 'Electrocardiographic Precordial ST‐Segment Deviations and the Risk of Cardiovascular Death: Results From the Copenhagen ECG Study', American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease, bind 3, nr. 3, e000549, s. 1-16. https://doi.org/10.1161/JAHA.113.000549

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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. Methods and 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, STelevations 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. Conclusion-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, STelevations in V2 to V3 were associated with a decreased risk of CVD in young men.",

keywords = "Adult, Age Factors, Aged, Aged, 80 and over, Cardiovascular Diseases, Denmark, Electrocardiography, Female, Heart, Humans, Male, Middle Aged, Proportional Hazards Models, Risk Factors, Sex Factors",

author = "Rasmussen, {Peter Vibe} and Nielsen, {Jonas Bille} and Adrian Pietersen and Claus Graff and Bent Lind and Struijk, {Johannes Jan} and Olesen, {Morten Salling} and Stig Hauns{\o} and Lars K{\o}ber and Svendsen, {Jesper Hastrup} and Holst, {Anders Gaarsdal}",

year = "2014",

month = jun,

doi = "10.1161/JAHA.113.000549",

language = "English",

volume = "3",

pages = "1--16",

journal = "American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease",

issn = "2047-9980",

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number = "3",

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TY - JOUR

T1 - Electrocardiographic Precordial ST‐Segment Deviations and the Risk of Cardiovascular Death

T2 - Results From the Copenhagen ECG Study

AU - Rasmussen, Peter Vibe

AU - Nielsen, Jonas Bille

AU - Pietersen, Adrian

AU - Graff, Claus

AU - Lind, Bent

AU - Struijk, Johannes Jan

AU - Olesen, Morten Salling

AU - Haunsø, Stig

AU - Køber, Lars

AU - Svendsen, Jesper Hastrup

AU - Holst, Anders Gaarsdal

PY - 2014/6

Y1 - 2014/6

N2 - 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. Methods and 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, STelevations 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. Conclusion-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, STelevations in V2 to V3 were associated with a decreased risk of CVD in young men.

AB - 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. Methods and 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, STelevations 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. Conclusion-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, STelevations in V2 to V3 were associated with a decreased risk of CVD in young men.

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KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Cardiovascular Diseases

KW - Denmark

KW - Electrocardiography

KW - Female

KW - Heart

KW - Humans

KW - Male

KW - Middle Aged

KW - Proportional Hazards Models

KW - Risk Factors

KW - Sex Factors

U2 - 10.1161/JAHA.113.000549

DO - 10.1161/JAHA.113.000549

M3 - Journal article

C2 - 24815495

SN - 2047-9980

VL - 3

SP - 1

EP - 16

JO - American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease

JF - American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease

IS - 3

M1 - e000549

ER -

Electrocardiographic Precordial ST‐Segment Deviations and the Risk of Cardiovascular Death: Results From the Copenhagen ECG Study

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