Association between isolated minor ST-segment and T wave changes with 10 years all-cause and stroke mortality

Minor ST segment and T wave (ST-T) abnormalities are commonly seen on the resting electrocardiograms (ECGs) of healthy individuals, but the long-term effects of these findings, particularly in the general population, have not been thoroughly assessed. As a result, our objective was to examine the link between isolated minor ST-T abnormalities in the general population and mortality from both cardiac and non-cardiac causes. The ECGs of 9035 participants within the Mashhad stroke and heart atherosclerotic disorders (MASHAD) study were evaluated. This was followed by a monitoring period of over a decade to investigate mortality results. The electrocardiograms were analyzed for ST-segment and T-wave irregularities using the Minnesota Codes classification system. Kaplan-Meier survival analysis was utilized to compare mortality rates for cardiovascular disorder (CVD), coronary heart disease (CHD), stroke, and all-cause death between cohorts with ECG alterations and those without. Individuals exhibiting isolated minor ST-T changes were predominantly female (p < 0.001), had a higher prevalence of diabetes mellitus (p = 0.031), and were more likely to be unemployed (p = 0.001). No significant differences were observed in age, marital status, educational attainment, smoking status, body mass index, dyslipidemia, and hypertension between the groups. Isolated minor ST-T abnormalities were identified as significant predictors of stroke mortality (p = 0.017). The presence of these ECG changes did not correspond to an increased risk of cardiovascular disease (CVD) or coronary heart disease (CHD) mortality. Upon adjustment for gender, employment status, and diabetes mellitus, the association between minor ST-T changes and all-cause mortality was p = 0.050. Individuals with isolated minor ST-T abnormalities were more likely to die from stroke. Therefore, it is advisable to implement preventive measures for the affected population, particularly women and individuals with diabetes, who are at higher risk of experiencing these ECG changes. Additionally, it is important to closely monitor the clinical status of those affected.