Resting electrocardiographic abnormalities as predictors of coronary events and total mortality among elderly men

Abstract

Purpose: To examine the prognostic significance of electrocardiographic (ECG) abnormalities among the elderly.

Materials and methods: The Finnish cohorts of the Seven Countries Study involved 697 men aged 65 to 84 years at baseline in 1984. A 5-year follow-up was made from 1984 to 1989. Fatal myocardial infarction, nonfatal myocardial infarction, and all-cause mortality were outcome measures.

Results: Seventy-four fatal myocardial infarctions (MI), 101 fatal or nonfatal Mis, and 207 deaths occurred. When electrocardiographic changes were analyzed one by one, men with Q waves (n = 98), high-amplitude R waves (n = 112), depressed ST-interval (n = 122) or T-wave changes (n = 263) had significantly (P < 0.05) higher risk of coronary events and all-cause mortality than men without these changes. Additionally, men with atrial fibrillation (n = 49) had significantly higher risk of death. Highest risk was observed among men with Q waves together with ST- or T-wave changes. Men with both ST depression and T flattening/inversions without Q waves had also increased risk, whereas this was not true for men with Q waves without concomitant ST- or T-wave changes.

Conclusion: Electrocardiographic abnormalities suggestive of coronary heart disease are associated with a high risk for coronary events and total mortality among elderly men. Among the elderly, a reliable history of coronary heart disease may not be easily achievable, thus the ECG could potentially be used as an indicator of symptomless or atypical heart disease.