Circulation, Vol 75, 347-352, Copyright © 1987 by American Heart Association
Y Liao, K Liu, A Dyer, JA Schoenberger, RB Shekelle, P Collette and J Stamler
The independent contributions of ST segment depression and/or T wave
abnormality (ST-T abnormalities) on the baseline resting electrocardiogram
to risk of 11.5 year coronary heart disease (CHD) mortality were explored
among 9203 white men and 7818 white women who were 40 to 64 years old and
without definite CHD at entry in the Chicago Heart Association Detection
Project in Industry. At baseline, prevalence rates of ST-T abnormalities
were age related for both sexes, and at every age the rate was higher in
women than men (age-adjusted prevalence rates 12.3% and 8.1%,
respectively). Univariate analysis showed that ST-T abnormalities were
associated with significantly increased risk of death from CHD for both men
and women. However, men with ST-T abnormalities had much greater
age-adjusted and multiple risk factor-adjusted absolute excess risk and
relative risk than women with such electrocardiographic abnormalities. When
baseline age, diastolic pressure, serum cholesterol, cigarettes/day,
history of diabetes, and baseline use of antihypertensive medication were
included in the multivariate analysis, ST-T abnormalities remained
significantly related to death from CHD in men but not women. The
interaction term between sex and ST-T abnormalities was at a borderline
level of statistical significance by Cox regression analysis. In
conclusion, ST- T abnormalities indicate an increased risk of subsequent
death from CHD independent of major coronary risk factors for middle-aged
U.S. men, but this is not clearly so for women.
ARTICLES
Sex differential in the relationship of electrocardiographic ST-T abnormalities to risk of coronary death: 11.5 year follow-up findings of the Chicago Heart Association Detection Project in Industry
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