In individuals without known ischemic heart disease or heart failure, pathological Q-waves were associated with an increased risk of death and hospitalization for IHD (44% vs 18%; P<0.001).
Cohort (n=5,381)
Does the presence of electrocardiographic Q-waves increase the risk of death and hospitalization for IHD in persons from the general population without known IHD or HF?
Even small electrocardiographic Q-waves are associated with a significantly increased risk of death and IHD hospitalization in individuals without known cardiovascular disease.
Absolute Event Rate: 44% vs 18%
p-value: p=< 0.001
AIMS: In individuals without known heart disease, electrocardiographic Q-waves predict a poor prognosis. We aimed to examine whether prognostic information can be derived from the size and location of Q-waves in persons from the general population without known ischaemic heart disease (IHD) or heart failure (HF). METHODS AND RESULTS: Electrocardiograms (ECGs) of 5381 persons without known IHD or HF from the 4th Copenhagen City Heart Study were reviewed and Q-waves were classified according to their size and location. Multivariate Cox proportional hazards regression models were used to examine the associations of Q-waves adjusted for age, hypertension, diabetes, and estimated glomerular filtration rate with the risk of the combined endpoint of death and hospitalization for IHD. During a median of 7.8 years of follow-up, 1003 persons reached the combined endpoint. One hundred and fourteen (2.1%) had pathological Q-waves, of whom 44% suffered from an event compared with 18% from the control group, P< 0.001. Persons with hypertension, diabetes, and impaired renal function were more likely to have Q-waves. Even small Q-waves (i.e. Minnesota code 1.2.x-1.3.x) were associated with a poor prognosis, hazard ratio (HR) 1.4 95% confidence interval (CI): 1.0-2.0; P< 0.05, though not as grave as large Q-waves (i.e. Minnesota code 1.1.x) HR 2.8 (95%CI: 1.6-5.0; P< 0.001). Conversely, there was no difference in the outcome of patients with anteriorly HR 1.6 (95%CI: 1.1-2.4) vs. posteriorly HR 1.5 (95%CI: 0.9-2.4) located Q-waves (P= 0.85). CONCLUSION: In the general population without known IHD or HF, even small Q-waves in the ECG are associated with a poor prognosis.
Godsk et al. (Tue,) conducted a cohort in Without known ischaemic heart disease or heart failure (n=5,381). Pathological Q-waves vs. No pathological Q-waves was evaluated on Combined endpoint of death and hospitalization for IHD (p=< 0.001). In individuals without known ischemic heart disease or heart failure, pathological Q-waves were associated with an increased risk of death and hospitalization for IHD (44% vs 18%; P<0.001).
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