Electrocardiographic abnormalities that predict coronary heart disease events and mortality in postmenopausal women:...

Area of Science:

• Cardiology
• Preventive Medicine
• Women's Health

Background:

• Limited data exists on the independent prognostic value of repolarization abnormalities specifically in women.
• Cardiovascular disease (CVD) remains a significant health concern for women, necessitating better risk stratification tools.

Purpose of the Study:

• To investigate the independent prognostic value of various electrocardiogram (ECG) repolarization abnormalities for coronary heart disease (CHD) events and mortality in a large cohort of women.
• To identify specific ECG markers that are strong predictors of cardiovascular outcomes in postmenopausal women.

Main Methods:

• A Cox regression analysis was performed on data from 38,283 participants in the Women's Health Initiative (WHI) study.
• Hazard ratios for combined fatal and nonfatal CHD events and for CHD mortality were evaluated for multiple ECG variables, adjusting for demographic, clinical, and therapeutic factors.
• ECG variables were assessed both individually and simultaneously in multiadjusted risk models.

Main Results:

• Wide QRS/T angle and ECG-demonstrated myocardial infarction (ECG-MI) were the strongest predictors of CHD events (HRs 1.90 and 1.62, respectively).
• Wide QRS/T angle, ECG-MI, and QT prolongation emerged as dominant predictors when evaluated together.
• For CHD mortality, wide QRS/T angle, ECG-MI, and high QRS nondipolar voltage were the strongest predictors (HRs 2.70, 2.41, and 2.18, respectively).
• Five ECG abnormalities were identified as dominant mortality risk predictors: wide QRS/T angle, ECG-MI, high QRS nondipolar voltage, reduced heart rate variability, and QT prolongation.

Conclusions:

• Ventricular repolarization abnormalities are significant predictors of CHD events and mortality in postmenopausal women, comparable in importance to ECG-MI and other QRS abnormalities.
• Repolarization variables and QRS nondipolar voltage warrant further investigation for their role in cardiovascular risk assessment in women.