Association of Nonspecific Minor ST-T Abnormalities With Cardiovascular Mortality

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Abstract
Electrocardiograms (ECGs) may be obtained at intervals from adults with a variety of cardiac or noncardiac diseases and from persons who undergo periodic health examinations. Nonspecific abnormalities are frequently observed in tracings of persons without clinical signs of heart disease. The most common nonspecific findings, ST segment or T-wave abnormalities or both (ST-T abnormalities), can be disquieting hints of latent abnormality that the physician may not be able to confirm or completely dismiss. Association of ST-T abnormalities, particularly major abnormalities, with increased risk of coronary heart disease (CHD) incidence and mortality has been reported.1-16 However, the prognostic significance of minor ST-T abnormalities is less conclusive,2,4,10,11,13,17-20 especially since most studies have not investigated minor ST-T abnormalities in the absence of other ECG findings.2,4,10,11,17,18 Furthermore, ST-T abnormalities are often transient.12,18,20-23 To our knowledge, no systematic study has been done to determine the relative prognostic importance of single ST-T abnormalities observed once only vs on 2 or more occasions, occurring months or years apart.