Abstract 1649: Minor ST Segment and T Wave Abnormalities Are Associated With Common Carotid Intima-Media Thickness but Not With Coronary Artery Calcium in a Middle-Aged, Biracial Population: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Background: Minor ST segment and T wave electrocardiographic abnormalities (STTA) are common and known to be independent risk markers for cardiovascular disease (CVD) events. Their association with subclinical atherosclerosis has been postulated but is not clearly defined. We sought to examine the association between minor STTA with common carotid intima-media thickness (CCIMT), a subclinical marker of atherosclerosis, in middle-aged white and black men and women from the CARDIA cohort.
Methods: We studied participants from the Year 20 examination of the biracial CARDIA cohort. This examination included measurement of traditional risk factors, 12-lead ECGs, coronary artery calcium (CAC) measurement and CCIMT. ECGs were coded using both Minnesota Code (MC) and Novacode (NC) criteria and defined as having isolated minor STTA (MC 4 –3, 4 – 4, 5–3, 5– 4) and/or minor STTA (NC 5.8). ECGs with secondary causes of STTA (ie. major STTA) were excluded from the isolated minor STTA analysis. Multivariable logistic and linear regressions were used to determine the cross-sectional associations of ECG abnormalities with CAC and CCIMT.
Results: The study sample consisted of 2585 participants with an average age of 45 years (57% women and 44% blacks). As shown in the table⇓, after multivariable-adjustment, the presence of minor STTA by MC and NC were significantly associated with the extent of CCIMT per 0.1 mm change (OR (95% CI): 1.18 (1.10 –1.28) and 1.19 (1.07–1.33), respectively). This association remained significant after further adjustment for ln (CAC + 1). Minor STTA were not associated with the presence or extent of CAC (data not shown).
Conclusions: Minor STTA, as defined by both MC and NC, were associated with the extent of CCIMT in this middle-aged biracial cohort. This study suggests that these ECG abnormalities may be risk markers for subclinical atherosclerosis. Further prospective investigation is warranted to elucidate potential mechanisms for this association.