Resting electrocardiographic abnormalities as predictors of coronary events and total mortality among elderly men

Purpose To examine the prognostic significance of electrocardiographic (ECG) abnormalities among the elderly. Materials and methods The Finnish cohorts of the Seven Countries Study involved 697 men aged 65 to 84 years at baseline in 1984. A 5-year follow-up was made from 1984 to 1989. Fatal myocardial infarction, nonfatal myocardial infarction, and all-cause mortality were outcome measures. Results Seventy-four fatal myocardial infarctions (MI), 101 fatal or nonfatal MIs, and 207 deaths occurred. When electrocardiographic changes were analyzed one by one, men with Q waves (n = 98), high-amplitude R waves (n = 112), depressed ST-interval (n = 122) or T-wave changes (n = 263) had significantly (P< 0.05) higher risk of coronary events and all-cause mortality than men without these changes. Additionally, men with atrial fibrillation (n = 49) had significantly higher risk of death. Highest risk was observed among men with Q waves together with ST-or T-wave changes. Men with both ST depression and T flattening/inversions without Q waves had also increased risk, whereas this was not true for men with Q waves without concomitant ST-or T-wave changes. Conclusion Electrocardiographic abnormalities suggestive of coronary heart disease are associated with a high risk for coronary events and total mortality among elderly men. Among the elderly, a reliable history of coronary heart disease may not be easily achievable, thus the ECG could potentially be used as an indicator of symptomless or atypical heart disease.