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

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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, ST-elevations 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, ST-elevations in V2 to V3 were associated with a decreased risk of CVD in young men.

Original languageEnglish
Article numbere000549
JournalAmerican Heart Association. Journal. Cardiovascular and Cerebrovascular Disease
Issue number3
Pages (from-to)1-16
Number of pages16
Publication statusPublished - Jun 2014

    Research areas

  • 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

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