Abstract 2312: Validation of the Prognostic Power of Newer Computer Derived ECG Criteria in Women
Background: The Women’s Health Initiative Study recently demonstrated that computerized measurement of QRST spatial angle was the most prognostic resting ECG measurement in women.
Objectives: To validate the prognostic power of QRST spatial angle and other computerized ECG measurements in women in a Veteran’s outpatient population with follow up for cardiovascular death.
Methods: Since 1987, digitized ECGs were recorded and analyzed using the GE/Marquette computerized ECG system. ECGs were ordered at physician discretion for usual clinical indications. As of 2000, 45,855 resting ECGs were available for consideration. After removal of inpatients, men, and those with pacemakers, WPW or QRS duration greater than 120 msec, 3578 women remained. Limited demographics were available (age, gender, race, weight, height, recording location) and the population was followed until 2002 and the cause of death determined using the California death index. Standard ECG criteria were compared to QRST spatial angle, damage scores, a simple summation score and T wave abnormalities. Age and heart rate adjusted Cox Hazard analyses were performed.
Results: The mean age and BMI were 56±17 years and 26.1±5.9. With 138 cardiovascular deaths, QRST spatial angle and Cardiac Infarction Injury Score (CIIS) were both independently associated with cardiovascular mortality and superior to traditional ECG diagnoses. A QRST spatial angle > 100 conferred a hazard ratio (HR) of 3.8 (95 %CI: 2.5–5.7) p<0.001, and CIIS of > 30 had a HR of 3.2 (95% CI: 2.0 –5.4) p<0.001.
Conclusion: Computerized ECG measurements including QRST spatial angle should be considered when evaluating CV risk in women since they are powerful predictors of cardiovascular death and superior to standard ECG diagnoses.