Isolated T-wave inversion on a routine resting ECG was associated with a significantly increased risk of acute coronary syndrome (RR 2.23; 95% CI 1.57-3.15) over a 20-year follow-up.
Cohort (n=1,997)
Does T-wave inversion on routine ECG predict acute coronary syndrome in the general population?
Isolated T-wave inversion on a routine resting ECG is a strong, independent predictor of future acute coronary syndrome in middle-aged men.
Relative Risk: 2.23 (95% CI 1.57–3.15)
BACKGROUND: T-wave inversion (TWI) is a frequently encountered electrocardiographic (ECG) finding during routine medical examination of asymptomatic individuals, and of patients with various clinical conditions. However, the role of isolated TWI in the prediction of acute coronary syndrome (ACS) in the community has not been extensively studied. We investigated the relationship between TWI in routine ECG and the risk for ACS in the general population. METHODS: This study is based on a random sample of 1997 men aged 42-60 years in Eastern Finland. Electrocardiograms recorded at rest were classified using the Minnesota codes. The association between isolated TWI and ACS was determined using a multivariable adjusted Cox proportional hazard model. RESULTS: Negative T-waves were present in 3.6% of the participants. During an average follow-up of 20 years, a total of 493 ACS events were registered. After adjusting for age, TWI was associated with a 3.10-fold (95% confidence interval (CI) 2.21-4.32) risk for ACS. After additional adjustment for previously known coronary risk factors, TWI remained statistically significant in predicting ACS (relative risk 2.23; 95% CI 1.57-3.15). Negative T-waves was one of the strongest risk markers for ACS compared with other ECG-based variables such as left ventricular hypertrophy, previous Q-wave and prolonged QRS duration. CONCLUSION: TWI has a strong and independent predictive value for ACS in the general population.
Bakhoya et al. (Wed,) conducted a cohort in Risk of acute coronary syndrome (n=1,997). Isolated T-wave inversion vs. No T-wave inversion was evaluated on Acute coronary syndrome (ACS) (RR 2.23, 95% CI 1.57-3.15). Isolated T-wave inversion on a routine resting ECG was associated with a significantly increased risk of acute coronary syndrome (RR 2.23; 95% CI 1.57-3.15) over a 20-year follow-up.
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