Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 30;72(1):75.
doi: 10.1186/s43044-020-00114-9.

Prospective associations between ECG abnormalities and death or myocardial infarction in a cohort of 980 employed, middle-aged Swedish men

Lennart Dimberg  1 , Bo Eriksson  2 , Per Enqvist  3
Affiliations

Prospective associations between ECG abnormalities and death or myocardial infarction in a cohort of 980 employed, middle-aged Swedish men

Lennart Dimberg et al. Egypt Heart J. .

Abstract

Background: In 1993, 1000 randomly selected employed Swedish men aged 45-50 years were invited to a nurse-led health examination with a survey on life style, fasting lab tests, and a 12-lead ECG. A repeat examination was offered in 1998. The ECGs were classified according to the Minnesota Code. Upon ethical approval, endpoints in terms of MI and death over 25 years were collected from Swedish national registers with the purpose of analyzing the independent association of ECG abnormalities as risk factors for myocardial infarction and death.

Results: Seventy-nine of 977 participants had at least one ECG abnormality 1993 or 1998. One hundred participants had a first MI over the 25 years. Odds ratio for having an MI in the group that had one or more ECG abnormality compared with the group with two normal ECGs was estimated to 3.16. 95%CI (1.74; 5.73), p value 0.0001. One hundred fifty-seven participants had died before 2019. For death, similarly no statistically significant difference was shown, OR 1.52, 95%CI (0.83; 2.76).

Conclusions: Our study suggests that presence of ST- and R-wave changes is associated with an independent 3-4-fold increased risk of MI after 25 years follow-up, but not of death. A 12-lead resting ECG should be included in any MI risk calculation on an individual level.

Keywords: Cohort study; Middle-aged men; Mortality; Myocardial infarction; Resting ECG; Risk factors.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Nelson-Aalen Cumulative Risk Estimates for Death by category in 977 men. Note: ECG category 0, ECG performed in 1993 and 1998, no ECGA; ECG category 1, ECG performed in 1993 and/or 1998 with one or more abnormalities; and ECG category 9, ECG performed in 1993 or 1998 without abnormality
Fig. 2
Fig. 2
Nelson-Aalen Cumulative Risk Estimates for Myocardial Infarction by category in 977 men. Note: ECG category 0, ECG performed in 1993 and 1998, no ECGA; ECG category 1, ECG performed in 1993 and/or 1998 with one or more abnormalities; and ECG category 9, ECG performed in 1993 or 1998 without abnormality
See this image and copyright information in PMC

References

    1. World Health Organization . Cardiovascular diseases. 2020.
    1. Mahmood L, Vasan W. The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. Lancet. 2013;383:999–1008. doi: 10.1016/S0140-6736(13)61752-3. - DOI - PMC - PubMed
    1. Galen of Pergamon : Ars Medica (ca 150 AD) in Hygiene, volume 1, Loeb classical library. ISBN 9780674997127
    1. Tunstall-Pedoe H, Kuulasmaa K, Amoyel P, Rajakangos AM, Pajak A. WHO MONICA Project. Myocardial infarction and coronary deaths in the WHO-Monica project. Registration procedures, event rates and case-fatality rates in 38 populations from 21 countries in 4 continents. Circulation. 1991;90:583–612. doi: 10.1161/01.cir.90.1.583. - DOI - PubMed
    1. Ioannou A, Papageorgiou N, Singer D, Missouris CG. Registry report of the prevalence of ECG abnormalities and their relation to patient characteristics in an asymptomatic population. QJM. 2018;111(12):875–879. doi: 10.1093/qjmed/hcy212. - DOI - PubMed

LinkOut - more resources