RESTING ELECTROCARDIOGRAPHIC ABNORMALITIES AS PREDICTORS OF CORONARY EVENTS AND TOTAL MORTALITY AMONG ELDERLY MEN

PURPOSE: TO examine the prognostic significance of electrocardiographi c (EGG) abnormalities among the elderly. MATERIALS AND METHODS: The Fi nnish 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 t o 1989. Fatal myocardial infarction, nonfatal myocardial infarction, a nd all-cause mortality were outcome measures. RESULTS: Seventy-four fa tal myocardial infarctions (MI), 101 fatal or nonfatal Mis, and 207 de aths occurred. When electrocardiographic changes were analyzed one by one, men with Q waves (n = 98), high-amplitude R waves (n = 112), depr essed ST-interval (n = 122) or T-wave changes (n = 263) had significan tly (P < 0.05) higher risk of coronary events and all-cause mortality than men without these changes. Additionally, men with atrial fibrilla tion (0 = 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 wave s had also increased risk, whereas this was not true for men with Q wa ves without concomitant ST- or T-wave changes. CONCLUSION: Electrocard iographic abnormalities suggestive of coronary heart disease are assoc iated with a high risk for coronary events and total mortality among e lderly men. Among the elderly, a reliable history of coronary heart di sease may not be easily achievable, thus the ECG could potentially be used as an indicator of symptomless or atypical heart disease.