Abstract 17972: Isolated Non-Specific ST-Segment and T-Wave Abnormalities on Screening Electrocardiogram is Associated With Incident Stroke Risk in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study
Introduction: Prior reports have shown that isolated non-specific ST-segment and T-wave abnormalities (NSSTTAs), a common finding on electrocardiograms (ECGs), are associated with a greater risk for incident coronary artery disease. However, the association between NSSTTAs and stroke has not been studied extensively in a racially diverse community-based population.
Methods: We used data from 14,077 participants (62.9 years, 40.4% blacks, 61.3% women) from the REGARDS Study, population-based, longitudinal study of white and black adults enrolled from 2003-2007 in the U.S.. Participants with a previous history of stroke, coronary heart disease, and any ECG abnormalities except for NSTTAs were excluded. NSSTTAs were defined from baseline ECG using the standards of Minnesota ECG Classification (Minnesota codes 4-3, 4-4, 5-3, or 5-4). Incident ischemic stroke events were validated by an adjudication committee through Sep 2015. Multivariable Cox proportional hazards regression was used to examine the association between baseline NSSTTAs with and incident ischemic stroke.
Results: A total of 3,111 (22.1%) participants had NSTTAs at baseline. During a median follow up of 9.6 years, 364 (2.6%) ischemic stroke events occurred. In a model adjusted for baseline age, sex, race, geographic location, and education level, NSSTTA were associated with a 36% higher risk of ischemic stroke (HR 1.34, 95% CI 1.06-1.68). With further adjustment for systolic blood pressure, antihypertensive medication, diabetes, dyslipidemia, smoking status, statin use, aspirin use, warfarin use, eGFR, albumin-creatinine ratio and CRP, the risk of stroke was 28% increased (HR 1.28; 95% CI, 1.00-1.62). Results were consistent in subgroups of the REGARDS participants stratified by age, sex and race.
Conclusions: Presence of NSSTTAs in otherwise normal ECG was associated with an increased risk of future stroke in this cohort of white and black adults. These findings raise doubts about the benign nature of these common ECG findings.
Author Disclosures: M. Sawano: None. Y. Yuan: None. S. Kohsaka: None. T. Inohara: None. T. Suzuki: None. T. Okamura: None. G. Howard: None. V. Howard: None. S. Judd: None. E.Z. Soliman: None. M. Cushman: None.
- © 2016 by American Heart Association, Inc.