Prevalences and association of ECG findings and cardiovascular risk factor in Shinawatra employees

Abstract

Objectives: There is significant incline trend in cardiovascular disease (CVD) mortality in developing countries such as Thailand and it is also the major contributor to the burden of premature mortality and morbidity throughout the world. In order to have well-stratified primary prevention plan, this study reports the prevalence of Electrocardiogram (ECG) abnormalities, as categorized by ECG Minnesota coding, and the association with major cardiovascular risk factors in Thailand.

Material and method: In this study, we use the same data from a previous survey at Shinawatra Employee but only subjects with available ECG's were recruited in our study. Standard supine 12-lead ECG data were collected; all amplitude and intervals were measured and entered into a computer manually. Then the ECG was coded according to Minnesota Coding system. The study characteristics, the prevalence of major cardiovascular risk factors and ECG abnormalities were calculated.

Results: A total of 1,485 subjects were recruited in this study, 638 (43.0%) were male and 847 (57.0%) were female. The overall mean aged was 34.4 (5.4). The level of major cardiovascular risk factors among men and women respectively were: total Cholesterol 215.6 (41.0) mg/dl (5.6 (1.1) mmol/l), 202.8 (35.3) mg/dl (5.3 (0.9) mmol/l); LDL-cholesterol 139.1 (37.0) (3.6 (1.0) mmol/l), 123.6 (31.9) (3.2 (0.8) mmol/l). Hypercholesterolemia was 65.3%, 49.8%. The mean systolic and diastolic blood pressures were 121.5 (13.9) mmHg and 81.4 (10.5) mmHg, 111.7 (12.2) mmHg and 74.5 (8.6) mmHg; hypertension 21.0%, 4.2%; fasting blood sugar 95.5 (15.8) mg/dl (5.3 (0.9) mmol/l), 88.0 (8.6) mg/dl (5.1 (0.5) mmol/l); diabetes mellitus 3.3%, 0.5%; body mass index 23.5 (3.5) (kg/m2), 21.3 (3.1) (kg/m2); obesity 30.7%, 11.0%; smoking 12.3%, 14.0%. The prevalence of ECG abnormalities, as categorized based on the Minnesota coding criteria, among men and women respectively were: Q/QS wave abnormalities (Code 1) 2.2%, 0.8%; S-T-J segment depression (Code 4) 0.5%, 1.4%; T-wave inversion (Code 5) 1.4%, 9.6%; atrioventricular conduction abnormalities (Code 6) 2.5%, 0.8%; and ventricular conduction abnormalities (Code 7) 0.2%, 0.2%.

Conclusions: This study reports higher prevalence of having major cardiovascular risk factors as compared to previous epidemiological studies in Thailand which should heighten the Ministry of Public Health concern to launch a better stratified preventive plan to combat the rising of coronary artery disease in the future. Moreover, this study is also the first study to report the prevalence of ECG abnormalities, as determined on the basis of the Minnesota coding criteria, and the association between major cardiovascular risk factors and the prevalences of several electrocardiographic findings in adult men and women in Thailand.