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首页> 外文期刊>European journal of preventive cardiology >Resting electrocardiogram predicts mortality in postmenopausal women with coronary heart disease or with risk factors for coronary heart disease
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Resting electrocardiogram predicts mortality in postmenopausal women with coronary heart disease or with risk factors for coronary heart disease

机译：静息心电图可预测绝经后患有冠心病或具有冠心病危险因素的女性的死亡率

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Background: Information about prognostic utility is limited for numerous electrocardiogram (ECG) abnormalities and is particularly scarce in women with coronary heart disease (CHD) or at increased risk of CHD occurrence. Design: This study used a prospectively planned observational post-hoc analysis of a negative randomised trial designed for other purposes. Methods: ECGs of 9789 postmenopausal women were analysed at a core laboratory. ECG abnormalities were determined and evaluated for mortality risk on top of established clinical risk factors and simultaneously with all other ECG abnormalities. Results: During a median follow-up of 5.6 years, 500 women sustained coronary death. Normal versus abnormal baseline ECGs were associated with an annual rate of 0.53% versus 1.28% coronary deaths. Ten clinically common ECG abnormalities, including left atrial abnormality, fragmented QRS, and Cornell voltage-only left ventricular hypertrophy, emerged as independent significant predictors of coronary death, eight of them also predicted all-cause mortality. Each ECG abnormality acted as a risk multiplier for a coexisting ECG abnormality. Two or three of any of the ECG abnormalities simultaneously present on the baseline ECG identified subsets with hazard ratios for coronary death of 3.3 or 5.5 respectively. Consideration of ECG abnormalities significantly improved risk stratification by common clinical parameters. Conclusion: The presence of ECG abnormalities provides independent risk information over and above that of established risk factors, both for women with CHD or at increased risk of occurrence of CHD. Normal ECG assures a low mortality risk regardless of whether CHD exists or not. The data derived could be applied to corresponding postmenopausal women in daily clinical practice.
机译：背景：关于预后效用的信息仅限于许多心电图（ECG）异常，在冠心病（CHD）或发生CHD风险增加的女性中尤其少见。设计：本研究使用针对其他目的的阴性随机试验的前瞻性计划性事后分析。方法：在一个核心实验室对9789名绝经后妇女的心电图进行了分析。确定ECG异常，并根据既定的临床风险因素评估死亡风险，并与所有其他ECG异常同时评估。结果：在5.6年的中位随访期中，有500名妇女死于冠心病。正常和异常基线心电图的年死亡率分别为0.53％和1.28％。十个临床上常见的ECG异常，包括左心房异常，QRS碎裂和仅康奈尔电压的左心室肥大，成为冠状动脉死亡的独立重要预测因子，其中八个也预测了全因死亡率。每个ECG异常都会作为并发ECG异常的风险乘数。在基线心电图上同时出现的任何两个或三个心电图异常可识别出的冠心病死亡风险比分别为3.3或5.5的亚组。考虑到ECG异常，可以通过常见的临床参数显着改善风险分层。结论：对于患有冠心病或发生冠心病的风险较高的女性，ECG异常的存在提供了独立于既定危险因素的独立风险信息。不论是否存在冠心病，正常的心电图均确保较低的死亡风险。所得出的数据可应用于日常临床实践中的相应绝经后妇女。

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