Predictive Value of ECG Ischemic Pattern Changes for the 10-Year Occurrence of Ischemic Heart Disease
Sara Saffar Soflaei1,2, Malihehsadat Abedsaeidi1,2, Eisa Nazar3
1Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Background:
The long-term prognostic value of resting electrocardiogram (ECG) in the prediction of ischemic heart disease (IHD) incidence and mortality in the asymptomatic middle-aged population is not well characterized. This study was designed to assess the prognostic value of major and minor ischemic changes in ECG as a potential screening tool in healthy adults.
Methods:
A total of 9035 middle-aged subjects with available ECGs were recruited. ECG ischemia was classified using the Minnesota Coding system. All the participants were followed up regarding the occurrence of IHD over 10 years. A cardiologist confirmed IHD, and additional tests were performed if indicated. Multiple logistic regression was applied to estimate the odds of ischemic changes in ECG to predict the occurrence of IHD. A p-value less than 0.05 was considered significant.
Results:
Among 9035 participants, 1225 (13.6%) had major ischemic changes and 1088 (12.0%) had minor ischemic changes. After a 10-year follow-up, 747 (8.3%) were confirmed with IHD (124 had died and 623 survived). IHD was more prevalent among men, older people, smokers, and retired subjects (p < 0.001). Both major and minor ischemic changes were significantly higher in participants with IHD (p = 0.001), while only major ischemic changes were associated with IHD-cause mortality (p = 0.004). These relationships remained significant after adjustment for confounding factors.
Conclusion:
Both minor and major isolated abnormalities in ECG are associated with an increased risk of long-term IHD incidence in the middle-aged population, while only combined major ischemia increases the odds of death caused by IHD.
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