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A negative T-wave in electrocardiogram at 50 years predicted lifetime mortality in a random population-based cohort
Helen Sjöland1, Michael Fu1, Kenneth Caidahl1,2
1Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Background:
Severe electrocardiographic (ECG) abnormalities in asymptomatic subjects correlate with cardiovascular risk.
Hypothesis:
The role of minor ECG abnormalities is less well-known. We evaluated the association between a negative T-wave and mortality, as a possible marker for prognosis.
Methods:
A prospective, population-based cohort, examined at 50 years, and followed until death. Time to death (event rates) and predictive role of a negative T-wave (Cox regression) were analyzed.
Results:
Participants (n = 839) with a negative T-wave (7.3%) had significantly higher blood pressure (BP) (mean systolic 157.9 mmHg vs 136.8 mmHg without negative T-wave, P = <.0001). A negative T-wave correlated with elevated risk (hazard ratio [HR] [95% CI] [confidence interval]) for all-cause and cardiovascular (CV) death (1.59 (1.20-2.11) P = .0012 vs 1.91 (1.34-2.73) P = .0004). The association remained after excluding coexisting Q/QS patterns and ST-junction/segment depression ECG abnormalities (1.66 [1.13-2.44] P = .0098 for all-cause vs 1.87 [1.13-3.09] P = .015 for CV death). Death from other causes was not associated with a negative T-wave. A major negative T-wave carried higher risk than a minor (2.17 [1.25-3.76] P = .0062 vs 1.78 [1.13-2.79] P = .012) for CV death.
Conclusion:
A negative T-wave at 50 years, in asymptomatic individuals, carried an increased risk of all-cause and CV death during lifetime follow-up.
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