Long-term prognostic significance of the ST level and ST slope in the 12-lead ECG in the general population

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Istolahti , T , Nieminen , T , Huhtala , H , Lyytikäinen , L-P , Kähönen , M , Lehtimäki , T , Eskola , M , Anttila , I , Jula , A , Rissanen , H , Nikus , K & Hernesniemi , J 2020 , ' Long-term prognostic significance of the ST level and ST slope in the 12-lead ECG in the general population ' , Journal of Electrocardiology , vol. 58 , pp. 176-183 . https://doi.org/10.1016/j.jelectrocard.2019.12.010

Title: Long-term prognostic significance of the ST level and ST slope in the 12-lead ECG in the general population
Author: Istolahti, Tiia; Nieminen, Tuomo; Huhtala, Heini; Lyytikäinen, Leo-Pekka; Kähönen, Mika; Lehtimäki, Terho; Eskola, Markku; Anttila, Ismo; Jula, Antti; Rissanen, Harri; Nikus, Kjell; Hernesniemi, Jussi
Contributor organization: HYKS erva
Päijät-Häme Welfare Consortium
Date: 2020
Language: eng
Number of pages: 8
Belongs to series: Journal of Electrocardiology
ISSN: 0022-0736
DOI: https://doi.org/10.1016/j.jelectrocard.2019.12.010
URI: http://hdl.handle.net/10138/327216
Abstract: Background: Even minor ST depression in the electrocardiogram (ECG) is associated with cardiovascular disease and increased mortality. There is limited data on the prognostic significance of ST-level changes in the general population. Subjects and methods: A random sample of Finnish subjects (n = 6354) aged over 30 years (56.1% women) underwent a health examination including a 12-lead ECG in the Health 2000 survey. The effects of relative ST level as a continuous variable and ST slope (upsloping, horizontal, downsloping) in three different lead groups were analyzed using a multi-adjusted Cox proportional hazard model separately for men and women with total mortality as endpoint. Results: The follow-up lasted for 13.7 (SD 3.3) years for men and 13.9 (SD 3.1) years for women. Lower lateral ST levels were associated with all-cause mortality in multi-adjusted models in both genders (at.) + 80 ms hazard ratio [HR] 0.64 for a change of 1.0 mm [95% confidence interval 0.49-0.84, p = 0.002] for men and HR 0.61 [0.48-0.78, p <0.001] for women). Associated coronary heart disease had no major influence on the results. Exclusion of subjects with ECG signs of left ventricular hypertrophy from the analyses increased the mortality risk of lower lateral ST levels in men but decreased it in women. For the anterior and inferior lead groups, no statistically significant difference was seen after multivariate adjustment. ST slope was not an independent predictor of mortality after multivariate adjustment Conclusion: Lower ST level in the lateral ECG leads is an independent prognostic factor to predict all-cause mortality in the general population. (C) 2019 Elsevier Inc. All rights reserved.
Subject: ST level
ST slope
Population study
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion

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