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Cited by 69ECG Monitoring and AnalysisCardiac Imaging and DiagnosticsAcute Myocardial Infarction Research

Prevalence, Prognosis, and Implications of Isolated Minor Nonspecific ST-Segment and T-Wave Abnormalities in Older Adults: Cardiovascular Health Study

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Kumar, Anita, Prineas, Ronald J., Arnold, Alice M., Psaty, Bruce M., Furberg, Curt D., Robbins, John, Lloyd-Jones, Donald M.·2008·Circulation
DOI 10.1161/circulationaha.108.772541PMC PMC2729590
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Abstract

Background— The prevalence and prognostic significance of isolated minor nonspecific ST-segment and T-wave abnormalities (NSSTTAs) in older adults are poorly understood. Methods and Results— 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. Conclusions— 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.

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  • In older adults, isolated minor nonspecific ST-segment and T-wave abnormalities (ST-segment depression or T-wave flattening or inversion <1.0 mm) are significantly associated with risk for all-cause mortality but not with nonfatal myocardial infarction.

    “ST-segment depression or T-wave flattening or inversion <1.0 mm was significantly associated with risk for all cause mortality but not with nonfatal myocardial infarction, suggesting that they may in part represent arrhythmogenic substrate.”

    From The Year of 2008 in Electrocardiology (2010) · cites this paper as [4]

  • Isolated minor nonspecific ST-segment and T-wave abnormalities in older adults may in part represent an arrhythmogenic substrate.

    “suggesting that they may in part represent arrhythmogenic substrate.”

    From The Year of 2008 in Electrocardiology (2010) · cites this paper as [4]

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Authors
Kumar, A., Prineas, R. J., Arnold, A. M., Psaty, B. M., Furberg, C. D., Robbins, J., & Lloyd-Jones, D. M.
Affiliations
  • Northwestern University (US)
  • From the Department of Preventive Medicine and Bluhm Cardiovascular Institute, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (A.K., D.M.L.-J.); Department of Epidemiology, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (R.J.P., C.D.F.); Department of Biostatistics (A.M.A.) and Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services (B.M.P.), University of Washington,...
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2008-12-16
Volume
118
Issue
25
Pages
2790-2796
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.108.772541
PMC
PMC2729590
OpenAlex
W2060727621
Cited by
69
References
44
Citations by year
2026: 3 · 2025: 4 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 1 · 2020: 8 · 2019: 3 · 2018: 1 · 2017: 3 · 2016: 1 · 2015: 3 · 2014: 6 · 2013: 6 · 2012: 4
FWCI
3.64
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (n01hc045133-001, n01hc085079-024, n01hc015103-009, n01hc085086-022, 5r01hl086792-03, n01hc55222-0-0-0, n01hc075150-004, n01hc035129-010)
  • National Institute on Aging (R01AG020098, R01-AG-15928, R01 AG20098, AG027058, R01AG015928, R01AG027058, P30AG024827)
  • National Heart, Lung, and Blood Institute (N01 HC085086, R01-HL-086792, N01 HC085079, N01HC‐75150, N01 HC85086, N01 HC035129, N01 HC015103, N01 HC55222, R01HL075366, U01HL080295, N01 HC055222, N01 HC075150, N01 HC045133, N01-HC85079)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords
older adults, coronary heart disease mortality, myocardial infarction, electrocardiographic abnormalities, cardiovascular risk, subclinical atherosclerosis, left ventricular mass, racial disparities, diabetes mellitus, blood pressure, body mass index
MeSH terms
Age Factors, Aged, Arrhythmias, Cardiac, Cardiovascular Diseases, Electrocardiography, Female, Health Status, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Cohort Studies, Prevalence

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